Discuss two areas of difficulty you encountered or two new nursing interventions

Discuss two areas of difficulty you encountered or two new nursing interventions you learned this week at your clinical site. You may also choose to share one of each. Please remember to respond to two of your peers.

Reply 1 To Me

The ongoing COVID-19 pandemic has the financial fortunes of many families due to jump in unemployment rates. As a result, many adults face the risk of severe depression to the extended period of lockdown and the implications of social distancing on work-related changes. In so doing, COVID-19 pandemic has exposed many adults to risks of depressive disorders due to hopelessness and anxiety surrounding the effects of the pandemic. Despite my qualified experience with nursing interventions for depression, I learned new interventions suitable for adults suffering from depression. The assessment of depressive patients requires nurses to assess the patient’s mental status regarding suicidal thoughts and hopelessness. Firstly, I learned that behavioral therapy focused on dietary changes could help adults to manage depression symptoms. Chatterton et al. (2018) states that foods rich in antioxidants, including Vitamin C, Vitamin E, and beta-carotene have a positive influence in the improvement of depression symptoms, enhancement of mood, and facilitation of healthy well-being. Also, “smart” carbs and fiber-rich diets could improve serotonin activity and enhance mood-boosting brain activities. Opie et al. (2018) argued that Mediterranean diet and protein-rich foods boost alertness and prevent thoughts of hopelessness and anxiety. In essence, a good and healthy diet enhance emotional well-being and promote optimal functioning of body systems, hence reduce depression symptoms.

Secondly, I learned the working mechanism of electroconvulsive therapy (ECT) and its effectiveness as a medical treatment in patients with depression and bipolar disorder. Weiner and Reti (2017) found that ECT comprises a brief electrical stimulation of the brain while the patient is under anesthesia to relief the symptoms of major depression. The experience with ECT encouraged me to conduct advanced research on brain stimulation treatments of depression. I appreciate the role of learning in a clinical setting since I get the opportunity to interact with patients and learn evidence-based interventions currently in use in the real-life care settings.

Chatterton, M. L., Mihalopoulos, C., O’Neil, A., Itsiopoulos, C., Opie, R., Castle, D., … & Jacka, F. (2018). Economic evaluation of a dietary intervention for adults with major depression (the “SMILES” trial). BMC public health18(1), 599.

Opie, R. S., O’Neil, A., Jacka, F. N., Pizzinga, J., & Itsiopoulos, C. (2018). A modified Mediterranean dietary intervention for adults with major depression: Dietary protocol and feasibility data from the SMILES trial. Nutritional neuroscience21(7), 487-501.

Weiner, R. D., & Reti, I. M. (2017). Key updates in the clinical application of electroconvulsive therapy. International Review of Psychiatry29(2), 54-62.

 

Teacher question: Hi Greter, these are 2 great points in combating depression, especially in this pandemic which seems to be making everything worse.  It’s no surprise that a healthy diet can improve serotonin levels.  I also had a student a few terms back who worked at an ECT unit.  She said the positive effects of ECT are amazing for many patients.  I would love to hear more about this, especially for those patients who depression & other mental health issues are significant barriers to a normal life.  Thanks for the references!  I plan on reading them!

 

Reply 2 Lecia

 

There are two areas of difficulty that I encountered at my clinical site at the rehabilitation center. One of the areas was ethical dilemmas.  Nurses face a range of ethical issues and hence need to harmonize their values with their professional nursing responsibility (Gágyor et al., 2019). Failure to do so can result in nurses facing legal challenges. While at the rehabilitation center, I realized that patients and their families were not entirely aware of clinical prognosis or existing treatments. The issue was of great concern to me as patients felt relaxed, asking me to explain what was being said by the physician. The ethical issue in this instance was how much information I needed to convey to the patient. Also, I faced the moral dilemma of how to handle incompetent colleagues. I felt the urge to report them because their actions threatened patients’ safety. However, I hesitated as doing so would cause inadequate staffing and hatred among staff.

The second area of difficulty that I encountered at the rehabilitation center was communication with patients. Efficient communication is a vital factor in quality health care. There is a robust connection between healthcare practitioners’ communication skills and patient health aftermaths (Afriyie, 2020). Undesirable communication between nurses and patients can happen either deliberately or accidentally. Concerning deliberate poor communication, I would give patients a lot of information as quickly as possible to create time for rest due to fatigue. On its part, unintentional due to fatigue, poor communication was caused by environmental factors. The rehabilitation center was quite busy and close to a busy highway. As such, there was much background noise which affected patients’ ability to hear. The noise affected mainly cognitive-impaired patients who tried to disguise by nodding and pretending to listen.