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A Holistic Care Plan for Addressing Anxiety, Depression, and Career Indecision

Mental Health Nursing

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A Comprehensive Care Plan for Jesse: Addressing Career, Housing, Mental Health, and Social Support Needs

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Supporting documentation of care plan

Person’s Need/Issue

Identified Goals

Interventions, actions & strategies to achieve goals

How will this issue be resolved?

Career indecision

A patient suffering from anxiety and depression finds difficulty in deciding on a career. The goal is to help him decide his career after discharge.

It is important to go for a career that makes Jesse happy. He does not want to go back to his army job and wants to be an ambulance paramedic. Proper guidance and counseling will help him to combat his problems and focus on his career (Onlineprograms.ollusa.edu, 2021).

Jesse is willing to pursue his new career and communicates with other people to resolve a job-related query (Dsa.org, 2021.

Inappropriate accommodation

Jesse has no connections with his friends or family and has no place to live. The goal is to help him find appropriate accommodation. 

A person with depression and anxiety, having a habit of alcohol consumption is quite sensitive and needs a safe place where he is not influenced negatively. Jesse wants to be an ambulance paramedic and needs safe accommodation where he can focus only on his career. The hostel can be a safe place to continue his education as smoking, alcohol, and drugs are not allowed in the hostels. (Hostelconnect. co, 2021) Getting a hostel will help him to solve his problem.

Jesse finds a hostel to stay in and starts preparing for his career.

Severe anxiety and stress

Living with anxiety and depression is not an easy task. Only counseling is not enough to combat them. Taking proper medications, which contain serotonin, dopamine, and nor epinephrine for mental health issues, is important (Mayoclinic.org, 2021). Jesse was previously alcoholic and taking medicines like Diazepam to give up alcohol (According to the given case study). The goal is to cure his mental issues and give up the habit of alcohol consumption.

Monitor him to make sure he does not consume alcohol and take prescribed medicines.

He is happy all the time and communicates with people, not feeling depressed or taking alcohol.

Unorganized time

Engaging him throughout the day will help him not to feel lonely or depressed.

Motivating him to resume his education and train him as an ambulance paramedic.

He is engaging in his appointed tasks and not feeling sad or lonely.

Lack of support from friends and family

Find him a new accommodation or work where he can live with others.

In the hostel, he can make new friends and while working in the hospital, communication with other people will make him feel better.

He has made many friends in the hospital and the hostel.

Script

Interviewing a psychiatric patient requires a lot of patience and dedication. There are many stages to conducting an interview. The points that I follow to deal with psychiatric patients are mentioned below.

It is very important to establish rapport with the patient. At the beginning of an interview session, I generally ask patients to introduce themselves. This introduction is followed by asking questions about the problems they are facing. During this time, I elicit specific questions to trick them to answer all the information that I need to know about them.

Finally, I ask them their doubts or any concerns that I need to remember.

Before starting the interview, I prepare a questionnaire, paraphrase them, and make them open-ended to give the scope of answering to the patients. I help patients to elaborately answer any specific topic, give examples to understand the questions. I usually avoid any jargon or technical words while elaborating the questions.

It is quite common to hear about people attempting suicide to get rid of all the problems. During the interview session, I ask them several questions if they do not arise spontaneously. The questions may be-

  • How lonely are you feeling these days?
  • Have you ever thought of hurting yourself?
  • Are you afraid of someone?
  • Have you ever thought of ending your life?
  • If you ever attempted suicide what held you back?
  • Where do you feel most unsafe? Etc.

Therapeutic communication is a set of questions related to the physical, mental, and emotional situation of the patient. Being a patient, I have to use therapeutic communication while dealing with the patients.

The points that I keep in mind during communication are-

  • Occasionally keeping silent to process the conversation and understand the situation properly.
  • To take out some time every day, for patients to know their mental conditions.
  • To seek clarification from patients every time they say anything confusing.

My last case was with a psychiatric patient who was suffering from depression, anxiety, and Obsessive-Compulsive Disorder (OCD). He was quite shy and introvert, and was not opening up to me initially. Sitting in one-interview and getting answers to all the questions was not easy. I used to spend more time with him in the cabin to know him more and found that he had suicidal tendencies. With the continuous effort of 2 years of psychologist, and mine, we were able to cure him properly. Now, he is happy in his life, pursuing his career and settling his future.

In the case of Jesus, he has lost his job in the Army, is not happy with his life, has no ambition, no friends to share feelings, and suffering from depression and anxiety. He used to be an alcoholic but now he is sober and taking Diazepam. He needs help to get back to a normal life. He has many issues which are- no home to stay in, jobless, no routine to follow, and no ambition or dream to chase.

Psychiatrists must be empathetic towards their clients. Showing empathy can only build rapport with the patients. This will help the patients to be more expressive. During interviews, patients tend to show discrepancies or changes in their behavior. It is important to support them and encourage them to achieve their decided goal. Sometimes, patients show resistant behavior. They do not want to change their behavior. At this stage, the psychologist or psychiatrist must motivate them and encourage them by saying they are capable of achieving everything they want. Lastly, it is important to understand clients and progress according to their behavior.

As an interviewee, I always try to conduct motivational interviews. The main components of a motivational interview are- OARS where ‘O’ means ‘Open-ended question’, ‘A’ means ‘Affirming’, ‘R’ means ‘Reflecting listening’, and ‘S’ means ‘Summarizing’.

The questions that I asked Jesse in the first interview sessions are-

  • Tell me about yourself
  • What is your favorite past time?
  • Is it ok to talk about your past?
  • If yes, can you tell me how your relationship with your parents is?
  • How long had you been working in the army before coming here?
  • Was it your dream to be an army officer?
  • If not, what is your dream?
  • Why did you not pursue your dream?
  • What were the challenges?

The questions that I asked Jesse in the second interview session-

  • Can you please elaborate on what problems you are currently facing?
  • Are you feeling lonely?
  • Have you ever thought of hurting yourself?
  • Have you ever thought of ending your life?
  • If yes, what did you do to come out of that situation?

24 years old Jesse is suffering from severe anxiety and depression. He has been admitted to the hospital. He had been addicted to alcohol but now he is sober for 60 days.

Jesse has many problems that include career indecision, inappropriate accommodation, severe anxiety and stress, unorganized time, and lack of support from friends and family. A care plan to solve all the above-mentioned problems is mentioned in the following. 

Jesus is facing career indecision. He wants to be an Ambulance paramedic. I counseled him about how he can achieve his goal. He is not in touch with any of his family members or friends and has nowhere to stay. I suggested that he should stay in the boys' hostel. A hostel is a safe place for him and has strict rules and regulations. If Jesse stays in the hostel, he can make new friends there and will not be feeling lonely, depressed, or anxious, and will not consume alcohol or any additives, as drugs, cigarettes, and alcohol are not allowed in the hostels. Jesse is suffering from anxiety and depression, so I suggested listening to music or engaging in any creative work like drawing, and taking medicines as prescribed by the doctors.

I have advised Jesse of many solutions to deal with all his problems. I have suggested that he take help from people, communicate with them, and share his problems. If Jesse is feeling happy all the time, not feeling depressed, talking with other people, making friends, and engaging in constructive work that means he is recovering from his mental conditions. The doctor prescribed him to make serotonin, dopamine, and nor epinephrine-based drugs. I am monitoring him to make sure he is regularly taking medicines. Sometimes, I talk to him and ask about his condition that makes him happy and feels good about himself.

References

  • Dsa.org, 2021, Finding the Right Job for You: Career Choices When Managing Anxiety and Depression, Available on: https://dsa.org.au/finding-the-right-job-for-you-career-choices-when-managing-anxiety-and-depression/ (Accessed on: Dec 1 2021)
  • Hostelconnect.co, 2021, Rules, Available on: http://hostelconnect.co.uk/rules/ (Accessed on: Dec 1 2021)
  • Mayoclinic.org, 2021, Types of antidepressants. Available on: https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046273 (Accessed on: Dec 1 2021)
  • Onlineprograms.ollusa.edu, 2021, How Guidance Counselors Help Students Decide on a Career Path. Available on: https://onlineprograms.ollusa.edu/resources/article/counselors-help-students-career/ (Accessed on: Dec 1 2021)
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