Nursing Study Guide: Depression

One of the biggest challenges facing the adult nurturing and caregiving patient populations is depression.
Careers and unemployment can both cause toxic stress in some people. Without positive well-being, a corrosive anxiety builds. Negativity can wind itself into behavior and thinking patterns.
The nurse in the Emergency Room and the nurse in the long term care facility will see depression at work in patients. And especially the home health nurse will see private pain and suffering on the part of their primary charges. Each kind of nurse will have to develop a technique for intake, analysis, interaction and treatment with a patient diagnosed with depression.

No longer is depression a disorder without a face. Tragedies in almost every state have appeared in bold face type. As a workplace hazard, across the United States,  an incident of violence or self-harm,  involving a depressed and mentally disordered person increases every day.

Nurse intake workers must carefully evaluate patients prone to addictive habits such as smoking, drinking, abuse of controlled substances, or unchararacreristic or destructive behavior.

The use of chemical substances and pharmaceuticals the treatment of depression has given rise to is a concern for many socially oriented activist groups and health maintenance organizations.

A variety  of caregiving professions, such as nurses, counselors, physicians, specialty providers, and treatment experts have been wrestling with the health problem that depression poses for centuries.
Today depression problems can cause an airline captain to plummet his plane and its passengers to their deaths. The depressed conductor of a rail train can lose focus and wreck the train cars, throwing everyone aboard off the track to injury or worse. Depression and other mental health issues are now squarely on the public eye.

First described in the literature of Freud as a “malaise”, postJungian medical practitioners regularly recognized symptoms of the disorder as far back as the early 1900’s. What became a cocktail party anecdote at first began to gain steam in the medical community. By the time World War One, military doctors were inventing wartime medications to combat this strange phenomenon.

Depression can present similarly in persons by unusual or destructive behavior, excessive alcohol and drug use, mood swings, or chemical imbalances in the blood. Lab tests can screen for these indicators,. which is why Emergency Room admissions will usually have a toxicity panel and blood gas analysis ordered before key triage decisions are made

It is the numbing of depressive individuals’ “inner world” that leads to an addiction to sleeping pills, diet pills, pain pills. and other abuses of limited- schedule prescriptipn medication.

Also, certain incidences of depression syndromes can affect people experiencing a significant life event. PTSD survivors survive traumatic combat ecperiences even though all persons with PTSD did not share the same exact event.

Depression can be suffered among persons who live similar but disparate lives. Today, patients can employ various strategies and methods to combat depression and the behaviors it exacurbates and the condition it worsens.

The patient groups and subgroups, as well as pools of invidividuals who have shared a significant life event, can fall into varying levels of depressive behavior.

People who survived the 9/11 terrorist attack on New York, for example, may have experienced a kind of depression called “survivor’s guilt.” Sufferers of this and many other types of depression are urged tovtalk to support groups and seek treatment from a licensed and qualified healthcare provider.

Nurses will often observe the symptoms of depression in both long-term and acute-care patients. In many cases, an acute-care life event such as a stroke, a heart attack, or a seizure might be triggered from conditions linked to depression.
The patient’s health and safety are paramount at all times. High blood pressure, drinking, drug abuse, atypical personality traits and characteristics of self harm might signal the presence of a depressive person or a depression disorder. Information regarding past treatments of depression be available in the medical chart.
The professional and care plan interventions for depression also can be psychological. A trained medical professional can analyze the patient’s history and recommend coping strategies. Together with a psychologist, the patient can try exercises aimed at breaking down the supporting anxieties of the depressive condition.
One thing a medical expert on treating depression will do is examine what circumstances or scenarios trigger the patient’s depression. Gaining perspective on one’s life and using physical and mental energy can give a patient a more level understanding of exactly a threat really is.
Mental health professionals have worked hard to remove the stigma of depression.Encouraging a patientbto get treatment is a much more effectice intervention.
After a treatment referral is done, outreach to a qualified provider is made. This depressopn therapist can devise techniques that eliminate the focus on negative patterns, self-destructive behavior, and developing a sad or poor attitude that can lead to a negative spiral.

At this point ending isolation and developing resources to prevent downswings in mood is a key dual goal. Gaining control of flexibility and less destruction to extremes can allow a person with depressive tendencies to steer themselves away from harmful behavior and towards goal-centric future rewards.

The Nurse’s First Day of Work

The first day of work as a nurse introduces a new student nurse or newly licensed nurse to the complex world of professional nursing. Occupational nursing, working for a living in the field of nursing and medical care, is a different challenge than merely answering test questions and performing nursing tasks for a limited number of patients and cases in a minute capsule of time. Putting on a show for a teacher or clinical preceptor is not as tiring as doing nursing tasks all day for inconsiderate or indifferent patients.

For new nurses, all too soon, after their first day, the workday becomes a repetitive chain of days that some new nurses find daunting. Nursing school wasn’t this much work!
Practical experience is what makes the most difference, in career nursing, because people are behaviorally trained to do what they have done before. Therefore, a nurse is best qualified who has done the same thing, medically speaking, for patients, over and over again.

Volunteer nursing experience and even intern duty at clinics can count. A nurse seeking work will want to demonstrate the most diverse and complete work history they can. The most complete medical knowledge level, and the most important skills are the accomplishments that nursing facilities and hospitals look for. A nursing home or hospital ward has enough of one thing, they are looking to fill a gap in skills, time schedule, or bedside manner.
A nurse coming into their first shift or first week of work, must understand that they are now the question “answerers” than the question-askers. people depend on them not only to do the right thing, but to say the right thing, and write the right thing in the chart. Nurses should get the knack early of writing vitals details of patients on little memo books or remembering case details all the way to the end of the shifts when it comes time to chart the patient responses. Keeping track of several different projects a day, even per patient, is a norm that new nurses must acclimatize themselves to. No nursing day on the job will be the same.

The new nurse should take in the data and treatment information they are given. Follow a single patient until you learn their medication schedule and care approaches. Nurses should use this time to observe all the things they can’t know from a patient’s medical chart, such as patient personality, manner, typical responses to questions.

The new nurse should show a minimum of argumentativeness, resistance to the process, or possession of too much superior work knowledge. The new nurse should understand that all the nurses she or he is working with have all gone through the process of getting to know the workplace and getting to know the patients and the staff procedures.

A new nurse should be watchful or ways they can improve on present nurse performers. The facility has hired new staff for a reason. Either they have worked the present staff to death, or you many nursing personnel have left. Local hiring pools give rise to dips and valleys in talent, and nurses may be working other jobs and not be available for all the shifts they are scheduled to work. The new nurse should make it look as attractive as possible for the facility to schedule them as much as possible.

The myth of a “nursing shortage” has come about for a reason. The fact is, nursing work weeks are set up to give nurses a break between long and arduous shifts. The anxiety and stamina that takes its toll on a nurse during the work week needs to fade away. A nurse needs time, sleep, and relaxation to unwind. The biggest advantage that a new nurse can bring to the table is their youth. The fact is, new nurses with strength and stamina to withstand long shifts of repetitive tasks and minute details are in demand. These nurses don’t come around every day. The best nurses get snapped up.

But the mistake most new and experienced nurses make is to try and fill all of their time with the most number of shifts. And nursing directors know that a nursing job candidate may not be as frank about their availability as they would want. The result is a kaleidoscope of co-workers instead of a reliable schedule of teammates.

A nurse should not assume another nurse will always be there to do a certain tasks or them or deal with a certain patient so they won’t have to. So, nurses cannot rely on a close set of friends on any nursing staff to function as a crutch. Social niceties like chatting, telling stories, or having lunch together should come second to attending call light systems and patient monitoring. A new nurse should be able to perform their duties no matter who is supervisor or charge nurse per shift. Long-term care can often be lonely and hard.

The hiring manager for a long term care facility or nursing home is trying to improve services to the public at all times. It is for them to review your skill set and decide how many nursing hours you can handle. Overworked nurses get sick, lose retention, and have mood swings. Often, nurses have second jobs whose work shifts do not complement well with the ‘primary” work assignment. For the respect of your nursing co-workers, try reporting your availability as honestly as possible. And don’t make a habit of coming late and missing the endorsement handoff.
The new nurse should treat the first day at work as the first day of the rest of their career. This is the last day their time is all their own. The patients now come first. The first time a new nurse punches in the time clock, all their focus and attention should be on patient directives and medical care objectives. From this beginning time onward, the nurse’s hands and mind are there to function for the good of the patient. This is the vocation of a career occupational nurse. Anything less of a commitment lacks the merit of a fully dedicated professional nurse.

What Nursing Students Need to Know-The Ancillary Tasks Expected on The Job

Student nurses are taught the ways to absorb and retain key nursing modules of knowledge and practical skills in blocks. But the actual practice of nursing is not so easily compartmentalized. Often skills can be packaged to fill overflow needs that become just part of every nurse’s workday. Student nurses can study their sections better when they understand how the interaction between knowledge and their job description intersect.

  1. MDS Documentation

The Medical Data Sheet comprises all of the elements of a patient’s case history and present conditions. The treatment history and current condition of the patients, the statistics of the vitals and the medication schedule are also cited. These are painstakingly compiled details that are critical in allowing the insurer to evaluate the patient’s case and future coverage, as well as the facility’s ability to perform required services. A nurse that can absorb this work when needed is a hiring gem.

The career path for a MDS Coordinator allows a nurse to train specifically for this position, although man nurses are assigned this duty as a matter of course. Resident assessment in long-term care is a monthly reporting process whereby a facility must sustain an error-free technique and perform a  mechanized reporting schedule that repeats every month for every patient in the facility. While  a specialist in MDS coordination can do this work full-time, in case of staff shortages or peak reporting times (like then end of the month), various nurses may be asked to volunteer for these tasks.

  1. Patient Scheduling Coordination

A hospital, skilled nursing unit or long-term care facility houses patients who need specialist and off-site services frequently. Even patients who receive Home Health or in-home nursing need professionally handled schedules from medical offices used to speaking with trained nurses who know how to deal with authorizations, No-Prior-Authorization providers, and patient needs. And confirmation of appointments and transportation is key to maintaining and improving patient health.

Nurses learning how to schedule patient appointments will learn to be patient with busy switchboards, other duties, and multi-tasking confirming and informing the appointment dates with the patient or case manager. Student nurses might think, “I’m not a secretary!” But a mere secretary cannot be trusted with HIPPA data and patient confidences, or make such calls, without a license. And only nurses can be allowed contact with patient chart medical data and the documents and information needed to complete this task.

  1. Pain Assessment

A pain assessment is triggered by observation of symptoms of pain in a patient, or by patient’s request, or by a scheduled recurrence for a patient suffering acute or chronic reported pain. Nurses are trained observe the symptoms of pain in  a patient, such as nonverbal sounds, vocal complaints, and facial expressions. Clenched teeth and wincing matter. Shortness of breath, rapid breathing, and other indicators of pain can be valuable, especially when endorses to other nurses to make them watchful of the same.

An attentive nurses picks up on these things. Patients who perform protective body movements or postures, or actual repeated complaints and nurse’s recorded and reported highest pain scores of pain ranges. The chart data for pain assessment can be extremely valuable when planning a pain management therapy strategy. And the integrity of thematically chart for the patient’s record can be maintained.

  1. Incident Reporting

The documents fabricate a narrative for evaluation and discussion. Staff at a nursing home often review the chart and an incident report can be valuable in planning the environment and actual care and nursing acuity for specific patients. Accuracy of simple facts like dates and times, clarity of writing, overall commitment to highest and best practices and student nursing preparation from the beginning of their career will allow the patient the best chance at an accord to the benefit of all.

  1. Health Insurance Case Investigation

Often patient or anonymous complaints generate a grievance or abuse allegation. Utilizing these grievance processes does not prohibit the legal rights of a patient, but will commit a facility to relate facts known and committed o the medical chart. Confidentiality is of the utmost concern in these situations. Nurse known to be capable of keeping secrets and handling important situations with poise and skill will be noticed for promotion and special recognition.

  1. Public Oversight Agency

The oversight agencies such as the Ombudsman programs involve the prompt and detailed investigation of any incident or claim. The recommendation of a case manager or family member can prompt further investigation of abuse claims or environmental violations. Civil code violations for patient care become a matter of record when allegations are substantiated by the investigating agency.

  1. Law Enforcement Testimony

During the course of any nursing shift, extreme incidents will arise. Patients will have altercations that become violent or abusive. Residents rights demand that such extreme incident be reported to local law enforcement. Often a patient’s family or a relative will be an outcry witness if they are present. To build a strong case, the attorney will review the police record. What a nurse says at this time will be key or the plaintiff or the defense.

So, when student nurses hear about MDS Documentation, they should understand that will be them someday. The first time they have to stay on hold for a doctor’s office longer than twenty minutes, to schedule one appointment, they should have anticipated this as part of a nursing career. When student nurses see a co-worker or stranger complain of pain or evidence nonverbal complaints, they should feel the prompt to perform a pain assessment.

     All of the book work and practical exams, intern ships and training sessions must combine to deliver skill sets that measure up to these challenges, as well as regular nursing chores. And student nurses should understand from the outset, that in any nursing career, that command of the facts is pivotal. A nurse managing information related to patient incidents, nursing investigations, and medical facility’s oversight agency communications are of ultimate importance. These combined tasks and skills,  as well a nursing student‘s learned abilities on the job, will make any nurse outstanding in her field.