Case Study Scenario
You are a newly registered nurse working in a large metropolitan hospital on an early shift in a busy ED/medical assessment unit. You have been allocated John Thompson to care for as a 1:1 special in a single bed side-room. You are given the following hand-over by the night duty RN:
John is a 28 year old man admitted yesterday after an overdose of Clonazepam, Sodium Valproate and Quetiapine. John has a diagnosis of Bipolar Disorder and is currently a referred patient on a Form 1A of the Western Australia Mental Health Act 2014. Overnight John has been occasionally drowsy, but at other times very restless and agitated. His conversation has some delusional content at times. He appears confused and is likely to be experiencing a delirium related to the intentional overdose of prescribed medications.
John has an intravenous line of normal saline 1 litre over 8 hours â€“ started 4 hours ago. The last ECG showed lengthening of the Q-T interval and a repeat ECG is booked for 10:00 AM today. TPR & BP are within normal limits â€“ check vital signs 4 hourly along with neurological observations until reviewed by the treating Medical team.
John’s behaviour has not presented any significant management problems overnight in the ward. However, when he presented to the Emergency Department he was in a severely agitated state and a Code Black (Aggressive incident & security response) was initiated. Because of John’s fluctuating sensorium she is to be considered ‘at risk’ and steps are needed to ensure her protection.
John is not to be given any medication unless severely agitated. The Consultation-Liaison psychiatry team are aware of her admission to the medical ward and will review John later this morning. Over the next few hours it is likely that John will become more alert and likely more distressed and agitated. You are advised to call for assistance if you have any concerns.
In a parting comment the night duty RN states, “I don’t know why we are wasting our time looking after a woman who wants to kill herself when there are plenty of sick people out there who need hospital beds”
Please extract the main issues and write about how the information given impacts the client, their family, and how it informs your nursing care and approach. Please use relevant research to inform your study and discuss these finding as applied to the case.