Diagnosis and Management of PTSD
Introduction
Reflective practice includes analyzing individual professional behavior to improve and develop. According to Jones et al (2020), it allows nursing students to learn and question from their own experience as well as to recognize the uncertainties that are part of nursing practice and considering the impact that patient’s issues may have on nurses. As a critical learning component in advanced nursing education, reflective practice can inspire nurses to develop self-regulated learning skills that can improve competence, professionalism, and humanism (Jones et al 2020). Besides, in nursing, reflective practice improves nurses’ satisfaction and patient care. Mental health nurses are responsible for assessing, diagnosing, and managing patients who present with mental health issues. During my placement in a mental health facility, I got to learn how most psychiatric illnesses progress gradually from acute to chronic. The mental status changes that accompanied most mental disorders compromised the patient’s ability to perform ADLs, QoL, social, education, or professional life. Diagnosis and Management of PTSD
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Nature of The CPD Activity And/or Practice-Related Feedback
Diagnosis and management of PTSD.
Lessons from The CPD Practice Experience
Placement in clinical settings continues to be a common practice for nursing students, particularly mental/psychiatric nursing. My placement in a mental setting positively influenced my ability to assess and connect with the patient’s actions, feelings, and thoughts to determine their needs. The ability to learn from practice and experience is an integral component of promoting professional development and growth in nursing practice. Attending to patients from different races, ethnicities, cultures, and religions, was a learning milestone. I attended to both adult and pediatric clients with different mental disorders and the most common diagnoses were PTSD (post-traumatic stress disorder), cyclothymic disorder, mild-moderate depression, bipolar disorder, and schizophrenia. A major case in point was a 55-year-old male patient who presented with complaints of a moderate headache after involvement in a road traffic accident. His GCS was 10 and a CT scan of the head was normal. On a scale of 0/10, he rated the headache to be 4/10. As I assessed this patient, the priority diagnosis from his history was a mild traumatic brain injury. However, after a thorough and careful analysis of the subjective symptoms and objective data, PTSD came to mind as another potential diagnosis.
Most patients presenting with migraines or headaches tend to have a history of exposure to traumatic events and other symptoms that are consistent with a PTSD diagnosis. After this realization, I decided to take a more comprehensive industry that revealed the patient was a married veteran who had just recently returned from Afghanistan. He opened up to having anger out of control, intrusive thoughts of war and death-related events, and combat nightmares that caused difficulty sleeping, and performing ADLs. As a result, he was extremely anxious and had lost interest in hobbies such as swimming and fishing that he frequently engaged in the company of his wife and children. On a particular day that he presented for care, he acknowledged that he had intrusive thoughts while cycling and was initially involved in a fight with drives who cut him off, cursed strangers who stood close to check outlines, and even shifted to ‘attack’ mode when passersby looked at him by accident. Diagnosis and Management of PTSD
Miao et al (2018) define PTSD as a mental disorder that results from exposure to stressors such as a manmade or natural disaster, combat, or other life-threatening experiences. It is a condition that causes significant impairment that is primarily characterized by symptoms of avoidance, arousal, and negative cognition changes. It is one of the mental disorders that raise concerns from the public with regards to the United States military operations in Iraq and Afghanistan (Miao et al., 2018). It is for the same reason that to date, several studies still report on its progress. Considering the financial, medical, and social implications that PTSD presents to individuals, families, and the nation, mental health nurses should be able to diagnose and manage patients under traumatic exposure.
How I Improved My Practice
I developed greater insights on how to consider PTSD as a priority diagnosis among patients who have undergone traumatic exposure. PTSD cases follow a traumatic experience resulting in severe symptoms that can interfere with the occupational, interpersonal, psychological, social, and physical functioning (Miao et al, 2018). This placement revealed how it was essential to accurately identify genuine PTSD cases among differential diagnoses as this also helps to rule out cases of false PTSD or prevents the likelihood to miss a PTSD diagnosis. I also learned that it is easy for clinicians to miss a PTSD diagnosis and this can significantly affect the care plan, management of resources, and patient outcomes. The most significant factors that increase the challenge of making an accurate PTSD diagnosis include; subjective stressors, symptoms that present stereotypically, and the involvement of most patients in disability, criminal, and civil evaluations.
I also learned that to increase the accuracy of diagnosing PTSD, clinicians can use standardized traumatic events assessments in the form of an unstructured interview. The interview that elicits information from patients regarding symptoms associated with each component of the PTSD diagnostic criteria. According to Reisman (2016), one such instrument is the CAPS (Clinician-Administered PTSD Scale) which helps to identify if the patient meets the DSM-V diagnostic criteria for PTSD. Diagnosis and Management of PTSD
Relevance to The Code
Preserve safety –ask for assistance from other highly experienced healthcare professionals with regards to assessing, diagnosing, and managing patients presenting with mental conditions.
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Practice effectively – gain additional knowledge required for effective and safe practice
References
Jones, J., Bion, J., Brown, C., Willars, J., Brookes, O., Tarrant, C., & PEARL collaboration (2020). Reflection in practice: How can patient experience feedback trigger staff reflection in hospital acute care settings? Health expectations: an international journal of public participation in health care and health policy, 23(2), 396–404. https://doi.org/10.1111/hex.13010
Miao, X. R., Chen, Q. B., Wei, K., Tao, K. M., & Lu, Z. J. (2018). Posttraumatic stress disorder: from diagnosis to prevention. Military Medical Research, 5(1), 32. https://doi.org/10.1186/s40779-018-0179-0
Reisman M. (2016). PTSD Treatment for Veterans: What’s Working, What’s New, and What’s Next. P & T: a peer-reviewed journal for formulary management, 41(10), 623–634. Diagnosis and Management of PTSD