Care of Mental Health This article consists of 13 pages and 3600 words. In order to have full access to this article, email us at thedocumentco@hotmail.co.uk
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Introduction
In this case study, a nurse investigates some of the common ethical and legal issues that occur on a daily basis in mental health nursing. The study is of a patient that was once under the care of the nurse. The study includes a brief outline of the patient’s case and discusses the ethical and legal issues that occurred during the care of this patient.
TThe study gives insight into the resolution of the case and possible recommendations for such cases.
The patient in question was admitted to the hospital while the writer was undertaking duty there. The patient’s name is not disclosed for confidentiality reasons and the National Midwifery Council Code of Conduct (NMC, 2015). The patient is simply referred to as the ‘patient’ throughout.
The patient suffered from delirium tremens and had a history of Schizophrenia.
Delirium tremens (DT) is an illness, which most commonly occurs due to withdrawal from alcohol after heavy use. Such patients are admitted because of the serious symptoms they display during the initial phases of withdrawal (Perälä et al, 2010). Schizophrenia is a severe disorder that affects an individual’s thought processes, emotions and actions. In some cases sufferers have difficulty being expressive, become unresponsive and can, at times, become violent and harmful (Zarit and Zarit, 2012). However, the symptoms and the behaviour varies in different patients.
Discussion
The writer discusses the care and treatment of this patient in the mental health care facility. A patient with a psychiatric disorder can be managed in many ways. Medication, supportive care, and even physical restraints are used for managing psychiatric patients. This patient represents a critical case because his symptoms of delirium tremens were amplified by his history of schizophrenia. Since the patient already had history of psychosis, he was more aggressive during the withdrawal phase. The symptoms, due to DT and psychosis, had progressed enough to make the patient depressed, violent and incompetent. He was unable to understand what was happening or how to cope with it. If medication and supportive care prove ineffective, the last resort is to restrain the patient whenever required to provide him medication (Pompili et al, 2013). In the case of DT, the second opinion appointed doctor (SOAD) has to decide what is in the best interest of the patient (Crown, 2017). According to . Nevertheless, in this case, such a declaration was not brought up.Care of Mental Health
The nurses and practitioners violated the Human Rights Act of 1998 S (3/8); the right to private life and freedom (EHRC, 2017). According to the opposition, they treated him against his will and used restraints to control him. In such cases, the psychiatric ward staff needs an authoritative approval from the Ministry of Justice regarding the treatment of the patient, as he had no family and was refusing treatment in his disoriented state. This means the governing body handles the cases, which need a guardian but do not have one for an incompetent patient. Conversely, such approvals can greatly complicate the method of treatment and the course of recovery. Governmental laws support patients; therefore, legal approval was required to proceed with the treatment.
The healthcare team must be able to justify the use of restraints, like limb straps and abdomen straps, under the local prevention and management of violence and aggression policy (Macavoy, 2017). For patients similar to the one in this case, covert medication is used for treatment (Videbeck, 2013). It is not common but has been used for necessary cases. This way, the resistance to treatment is reduced. However, this method of administering medicine is justified by the NHS, (2012) in the Guidance for the Covert Administration of Medication.Care of Mental Health
Legal Problems
The writer discusses here the mental health issues that nurse’s face during patient care, focusing on the patient in question.
It is the patient’s right to refuse treatment, but the issue of refusing medication in the case of psychiatric patients is a matter of debate in the courts as they are incompliant majority of the times when they refuse treatment. There is yet to be a decision made regarding this issue. The patient has the right to informed consent and the existence of a psychiatric disorder does not impede this right. However, in a hospital setting, the health team gives medicine with the assumption of implied consent, as not all institutes require informed consent for every single act (Blythe and White, 2012). Implied consent means that a person has indirectly consented to treatment and management according to the situation; in this case, the patient was admitted in the hospital giving an implied consent to treatment.
Care of Mental Health A patient is considered competent until proven otherwise by a set of physicians after using competency assessment tools (Townsend, 2014). If declared incompetent, a legal guardian or professional decision-maker at the hospital is appointed for the patient. The health team violated this law, 23 (3A) (MHA (2007), because the patient had no legal guardian and no legally assigned decision maker before they started their management.
Another legal concern that came up during the care of this patient was the fact that covert medication was used to provide him with the medication necessary to avoid the aggression he showed at the sight of any medicine. Covert medication means providing medicine in a camouflaged way, such that the patient does not understand what is being taken (Videbeck, 2013). This method can involve giving the patient food or drink infused with medicine. As a result, the individual, unsuspectingly, consumes what is provided without knowledge or consent. This is done when the patient is non-compliant or aggressive, but when treatment is necessary to control the condition (Latha, 2010). Sometimes, convert medication can raise legal and ethical issues (Spicker, 2011). Such misconceived methods include making medication easier to consume by assisting it with drinks or food.
There are strict rules for the use of restraints. Restraints can be chemical or physical, but both are supposed to be adopted as last resorts (Griffith and Tengnah, 2017). When a patient needs to be managed by using restraints, seclusion should be the first method adopted as restricted should be minimized to provide liberty according to MHA (2007) Section 8 (2Bc). If seclusion fails to control the patient, then physical restraint can be used. However, restraints should cause no harm to the patient, should be adopted only when the patient is harmful to others, should be used for the shortest possible period and are allowed only if the patent suggests that the measure must be taken (Norman and Ryrie, 2013).
Tort law is the set of regulations that help the patients who have suffered due to someone else’s irrational acts. The Tort law can be used against…..
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