When addressing the interconnection between mental health and physical health I feel as though they are often viewed in two separate lights, when in fact they play pivotal role within one another. As future nurses our role is to identify and care for individuals who are ill. Whether they come in with physical pain or pain that is unseen to use, we must address it and care for them to the best of our ability. When I began my goal of becoming a nurse, I always knew I wanted to make sure to always have a holistic approach. Specifically, caring for the entire human; physically, socially, environmentally, psychologically, culturally, religiously, etc. With holist care also comes the large factor of Mental Health. Mental health is often overlooked as a factor in patient care, when in fact it can give us a better picture of a person’s care needs.
When looking back on my clinical experiences I have had the opportunity to work with a various number of different patients. All coming in for specific care of an illness, disease, injury, etc. Whereas this semester we had the opportunity to work within a behavioral and mental health care facility at SMHC Medical Center Sanford. With this came the time to really get to know our patients and their backgrounds of mental health. One patient who I often think about their complex interconnections with their physical and mental health is a young woman age 33, who came in for drug-use help, after having severe withdrawals from heroin. She was a young mother of two, who was stuck in an abusive relationship that the center was their drug. As she comes into care of any facility is important to address her priority needs of care but not diminishing her mental health. As a young woman who seems to have had an extensive history with her struggles of mental health and now adding into the mixture a drug addiction, we as the care team must care for the entirety of her complex needs. The day I spent with the patient she had full insight her both her drug addiction as well as her mental health state that led her to where she was. She presented very determined and hopeful of her future.
There are many aspects that come into play when taking care of a patient and one of the more important areas to take notice of when evaluating a patient is their social domain. The social domain is an important factor to evaluate because it tells the health care team what supports and aids the individual has outside of their walls. By having outside supports a patient’s overall health can improve immensely because they don’t feel alone or like they are doing this alone. During my time with my patient, I was able to assess some areas of her personal life. By doing this, especially as a student, you do not want to seem as though you are prying or make them nervous. Although she is in an abusive relationship that has been shared and documented, her two sons have been removed and are safe. One living with her mother and the other has been placed in foster care. She does have friends and seems to be socially engaged on the unit. Her goal once leaving the hospital is to re-gain custody of her children and work on getting herself back on her feet. With these factors although they seem reasonable it is important to make sure that the patient has other outside supports. Such as NA groups, support groups for other single mothers, support groups for individuals of abuse, and other social outlets for her everyday life. I believe every individual should go to therapy or receive counseling because it can only benefit you to have a third, nonjudgmental, individual here your thoughts.
For each domain, there are nursing diagnosis’s that identify my patient. Based around both her drug addiction and her mental health journey, she has affected areas in each. For the social domain specifically, we can use the nursing diagnosis of ineffective coping. This is due to her extensive history of abuse, family trauma, limited coping skills, seen through her choices. Although she has the support of her mother caring for her son it was not listed of any other supports so this can lead to ineffective family and trauma coping. Seeing that although she had family support there, she turned to other outlets. Due to her past trauma the patient could be avoiding the proper care for herself and in turn the proper care for her children. By isolating oneself and not turning for help the cycle of addiction becomes never ending. For the biological domain, the nursing diagnosis could be self-care deficit. Having a drug addiction can be due to numerous amounts of things, as well as the physical toll it takes. Specifically, with heroin addiction patients we can see track marks on arms, legs or toes, mood swings, slurred speech, physical appearance changes, etc. Making sure the patient has an outlet to address these self-care deficits and see them clearing after getting clean. With self-care deficits comes depression and anxiety so working with the patient to address these factors and work through the goals moving forward. Lastly being the psychological domain, this being the most important factor I feel for this patient. When coming out the other side of addiction and the withdrawal feelings patients tend to have a hard time adjusting to living a clean/sober live. The nursing diagnosis I would place within this domain is risk for relapse, as well as risk for suicidal ideation. As stated before, when becoming clean and seeing all the pain you could have caused to yourself and loved one’s people can lose sight of why they got clean in the first place and relapse. Or see the damage they have done and their risk for suicide increases. This patient might not know how to adjust to a clean life, or they might feel as though they can’t “get better” or “make things right.” It is a time when the individual feels defeated. With, it being our job as her care team to implement nursing interventions to better care for the patient and help her on her physical and mental journey.
The priority nursing interventions specifically for my patient’s mental health will be assessing and monitoring the severity of each of these domains. By this we can address and implement the proper care individualized to the patient. As well as monitoring her previous medications history and altering it to fit her current needs. If any medication changes do occur it is the nurse’s job to educate the patient on the medication, its adverse effects, and any black box warning signs they need to be on the look for. Lastly, giving the patient the resources, they will need outside of the hospital to continue their care and have a larger support system. With these nursing interventions in place, it is the hope that the patient will receive holistic care in all areas of the domains. It is essential for the nurse to provide the proper care and build a trusting and hopeful relationship, so that when they implement these interventions the patient will feel understood, supported, and cared for.
Through these domains the nurse can thoroughly address the interconnections between Mental Health and Physical Health. Each domain is built specifically by looking at the patient as a whole and making sure they are provided care in each area, and if not implementing a care plan to provide care in a lacking domain. I feel as though these domains are a structured way in which healthcare providers can give their patients holistic care. Making sure that each domain has supports and access to both the physical and mental needs of the patient.
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