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 Mechanics of Nursing

nursing equipment

vital statistics 

One of the realities of every profession is that an occupationally trained worker must provide some part of their own tools of the trade. Perhaps they prefer a certain brand or model, and/or the facility hospital or nursing home does not provide up-to-date or working machines at all. Officially, a hospital or long term care facility will monitor the medical equipment, but this does not always happen. Nurses are often “stuck” using equipment that is borderline inoperable or unreliable. This is a very serious medical issue because the nurse must be able to trust the statistical metrics to assess and record the patient’s condition.

Due to low budgets and straining costs, many facilities may not have the money to replace aging or broken equipment. Thus the patients are relying on the nurses to be able to do a manual job of taking blood pressure stats every time. This can be time-consuming and a stressful part of the nurse’s day, when conflicting patient needs stress the limited time a nurse has to finish tasks. A professional nurse must be able to contend with broken or inoperable equipment and yet smoothly transcend this challenge for ongoing patient care.

One of the parts of nursing that always gets nurses technically caught out is the working and proper maintenance of the medical equipment. Many a testing and practicals skills environment training stresses the use of blood pressure tests using the old-fashioned lub-dub method. But many professional nurses grow to rely on the wrist machine, used to calculate digitally the readout of the patients blood pressure and oxidation. Investing in this mechanical device can save time and trouble taking vitals readings.

A nurse working at a hospital or long term care facility should catalog the errors they observe using a particular piece of equipment and report this in writing to the charge nurse or to the Director of Nurses. They should note for the record in the licensed nurse progress notes how many times the attempted the vitals test and what the time was from beginning to end. This can be verified using a video camera or the notes of the charge nurse.

It is important for any nurse to immediately report a malfunctioning piece of equipment to the working charge nurse per shift, additionally. Taking a digital picture with your cellphone may also show the strange result or wrong code on the LED that multiple attempts can give. This advise is not just boilerplate for an in-service or training video. A nurse should use their own judgment and be ready to submit this letter anonymously to whistleblower line or local ombudsman or patient safety suggestion box.

Documenting the issue with the nursing equipment that it is not operating correctly and the serial number or identification tag will also assist inventory staff using this complaint to take the unit in for repairs. This way the nurse has a concrete record of their own observations and the method they used to pass the information up the chain of command. Sometimes the persons in charge of purchasing and equipment maintenance don’t have any interaction concerning the operability of the equipment, when in fact a vitals cart or heart monitor may need replacing.

Other equipment related to patient safety is elevators, stairs, fire escapes, visitor chairs, bed rails, bathroom safety rails or bars, light fixtures, air conditioners or heaters, and more. Elevators should work without strange or unexpected delays, or stops on unselected floors. Lighting and access to floors using fire escape doors or flights of stairs should be reviewed for safety practices. Lack of integration of security responses for patient alarms and wheelchair alarms can make a nursing ward seem like a zoo of noise, buzzes, and call light alarms.

But specialized equipment is not the only device that a nurse should review for safety. A nurse should always give the equipment a “weather eye” and see if the cord goes in smoothly and does not pull away from the electrical socket, or that the wheels or runners turn and move smoothly. A tray table or table-based electrical equipment aid to nursing may need to be monitored for electrical discharge. A nurse should report when a patient organize belongings or possessions in a manner that conflicts with safety standards.

Even finger protectors made of plastic can prevent paper cuts. This is a serious problem for blood contamination of medical records and documents, as well as droplet contamination between nurse and patient. Given the amount of time that nurse spend handling the chart pages, even a small paper cut can become painful upon repetitive action.

As always, the most highly scrutinized equipment for nursing use is the needle. Privacy, calm and well-lit circumstances in administering patient care, and a good understanding of the patient is required. Advise the patient when you are going to stick them, how long it will be, how the site looks, and ask them again before you inject the needle if they are ready. This use of courtesy centerlines patient dignity even during a difficult procedure. Improving stick skills should be paramount. Causing bruises or painful injection sites repeatedly in a patient can result in being written up by a supervisor. Continuous disregard of patient dignity and skin fatigue or tearing, bruising or discoloration due to improper needle skills can be means for dismissal.

All in all, there are numerous challenges to safeguarding patient safety and mechanical device security in the occupational nursing workplace. But with attention to detail and a good attitude, the professional nurse can overcome obstacles while providing excellent patient care.

 

 

 

Nursing and Infection Control

The reality of infection control may seem academic during pre-qualification for a nursing license. But there are processes for nurses to control infection spread and treatment. The methods include assessing each patient daily, reviewing admission paperwork and examining the patient and conducting body checks. The ways nurses can control infection are via infection containment and MRSA notification, timely endorsement to other nurses, and testing for infection via lab work.

Some nurses may not understand until they function professionally that a patient may exhibit symptoms of an infection, but they don’t necessarily understand what the symptoms mean when taken together. Thirst, reddening of skin, maceration of wounds or sores, drainage, excessive urination, and other symptoms should spark a curiosity in a professional nurse. The occupational nurse should investigate whether or not the patient is at risk for infection from environmental contagion or systemic vulnerability.

Nurses can order the room of a patient cleaned after a number of visitors have passes through. Contamination from referral nurses like LVNs and CNAs can increase total chance of a patient becoming infection. Immunity system diseases can encroach upon vulnerable patients because they do not have enough defenses like a working nurse, charge nurse, or student nurse intern. Patients can also carry germs and pass them on to other patients in group activity settings.

The patient most take care to limit contact with new sources of foreign bacteria. Housecleaning staff who go from room to room CNA spread infection by failing to clean their mops, brooms, and shoes. Hygiene should be of the highest caliber for every nurse. High-level infectious disease wards have housecleaning done with rubber booties on the shoes of all staff, as the bottom of shoes comes into contact with ground debris. This can be the nucleus of a horrible infection or a vulnerable patient with e reduced strength immune system.

In some cases, infections of the throat or gums, cuts or scrapes, and pre-existing wounds or sores can lengthen a patient stay in a hospital or long term care facility. A nurse who feels they don’t have to wash their hands between insulin administrations or pills disbursements may find themselves distracted and end up handling the medication with their bare hands. Nurses who often carry medication in their pocket may drop it, and whomever picks that up may in a world of trouble.

Care taken during specimen gathering can be crucial. All specimens should be considered potentially infectious, or hazardous, especially when exposed by contact with skin breaks. All methods and nursing procedures should be followed. Droplet infections, airborne infections, contract infections and potential blood borne infectious material pose the greatest risk. Viruses, parasites, fungi and bacteria must be watched for. Disinfection, sterilization, antisepsis and sterilization can be the nurse’s friends in aiding for the containment of infectious diseases.

Nurses may convey infectious bacteria (unintentionally) by traveling from a room with infection control and transmitting germs to the room with a patient where infection control methods are not being observed. Nurses have a burden of care for public health safety, not just the comfort of one patient. Patients who resist bathing and cleaning should be counselled for an intervention. Nurses should be wary that infectious bacteria can travel from room to room, person to person, with trays, silverware, instruments, supplies, wound care materials, sharps, and ungloved hands.

Nurses should caution other nurses and staff from letting down the standard of care by providing the patient with infection risks. Cluttered paths of travel, untidy patient rooms, incorrect bed elevation, incorrect shoes or clothing, all can play a part in posing a risk to infection control. Wet floors, back safety, fall prevention and care when working with chemicals should help any nurse do their part looking out for infection containment.

A patient who is consistently dirty is at risk for infection. A patient who refuses to bathe or change clothes can pose an infection risk to themselves or others. Dirty gowns, unwashed hands or unwashed flesh, torn surgical gloves or broken seals or opened packages should prompt a concern for the prevention of infectious disease. Sterile masks and protective equipment, environmental cleanliness, disinfection and sterilization can prevent disease breakouts and ensure better health care.