Mental Health Case: Li Na Chen, Part 1 Guided Reflection Questions Opening Questions How did the simulated experience of Li Na Chen’s case make you feel? The Li Na Chen simulation made me feel helpless in a way that I’m not used to. I’m not used to mental health ailments so much as the physical ones. I think that mental illness is just as real as physical illness and wish it was more prioritized in our current society. Talk about what went well in the scenario. I was able to carry out providers orders while also offering support to both the spouse and the patient. I was also able to educate the couple about Li Na Chen’s condition and what medical providers would be doing to help her manage her condition. Reflecting on Li Na Chen’s case, were there any actions you would do differently? If so, what were these actions and why? I would ask less redundant questions. I’m not sure if the simulation mandates asking every single question however it felt unkind to me to ask different iterations of the same question such as “do you have pain?.” When the patient answered “no” asking “where is your pain located” and then “how would you rate your pain” felt like putting Mrs.Chen through consistently answering the same question which was insensitive to the fact that she wasn’t feeling well. Scenario Analysis Questions* PCC What priority problem(s) did you identify for Li Na Chen? Priority problems that I identified in this case was major depression and risk of suicide. What potential problems could arise due to the major depression? Problems that could arise are helplessness/hopelessness which could compromise the safety of herself and those around her. These feelings often lead to individuals to attempt suicide and these emotions are evident in Li Na Chen. S/EBP Identify potential patient safety interventions related to Li Na Chen’s suicide attempt. A potential patient safety intervention is removing any potential risks for harm/self harm such as, sharp objects, laces, regular chairs, etc.. I would also implement 15 minute checks to ensure patient safety. PCC/ From vSim for Nursing | Mental Health. © Wolters Kluwer. T&C EBP Discuss Li Na Chen’s developmental stage according to Erikson and the importance of individual and group counseling with other adults who have attempted suicide. Based on Mrs.Chen repeatedly saying things like “she has no energy to complete activities that bring her joy and that it is only her family that she cares about and not herself” I would say Mrs Chen is in the middle adulthood stage of generativity vs. stagnation. She also expressed feeling like a failure and like life crumbles around her. These statements while vulnerable and honest are also very evident of generativity vs. stagnation. Group counseling would benefit her because of the camaraderie in knowing that she is not alone and that there are others like her. There is also the possibility of someone a little further in their healing being able to inspire her in knowing there is hope for recovery. At the very least the group would be willing listening ears. How could the change in the medication regimen have impacted Li Na Chen’s mental state? The change in medication was hit or miss because not every medication works for everyone. Mrs. Chen’s previous medications could have been more effective for her specifically therefore when her medications changed there could have been a change in therapeutic effect causing her condition to worsen. PCC In Li Na Chen’s situation, what therapeutic communication techniques would be most effective? I noticed that the therapeutic technique of probing did not work for Mrs. Chen’s situation. When I probed for more information she would cry harder and shut down. However, when I used the technique of restating she was more likely to respond well and offer more infomation up. She would also cry less which allowed for better communication. Concluding Questions Describe how you would apply the knowledge and skills that you obtained in Li Na Chen’s case to an actual patient care situation. Through this simulation I learned to always ensure scene safety before immediately jumping into care. I also learned that not every therapeutic technique will work for someone. I would apply my nursing judgement to see if a patient would rather I probe for information or if theyd like for me to restate and allow them to offer that information themselves. I also learned to remember to ask if the patient is comfortable with someone else in the room as they speak. * The Scenario Analysis Questions are correlated to the Quality and Safety Education for Nurses (QSEN) competencies: Patient-Centered Care (PCC), Teamwork and Collaboration (T&C), Evidence-Based Practice (EBP), Quality Improvement (QI), Safety (S), and Informatics (I). Find more information at: http://qsen.org/ From vSim for Nursing | Mental Health. © Wolters Kluwer.
