Communication and Counselling

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Critical incidents are occurring at all times, it is something that happens to a patient, their family or to the nurse. It can be positive or it could be a situation where someone has suffered in some way . Through this assignment, the author’s feeling about the whole interaction between the author and the client involved will be explored and evaluated. Through reflection which is described as a process of reviewing an experience which involves description, analyses and evaluation to enhance learning in practice (Rolfe 2001). This incident also made the author is more aware of the inadequacies as a mental health clinician due to lack of knowledge and experience with the client’s dementia and how this could be learnt from to prevent the same mistakes from occurring again. This assignment will also summarize in what the author had achieved through reflection of this critical incident and provide recommendations for future practice. Description of incident:

The incident occurred in the client’s own home environment and it involved the client, his wife and two community mental health clinicians. Client is Mr. SS, a seventy –two year old man at the time of the incident was living in his own home with his sixty-eight year old wife who also is his main care giver. Client has a diagnosis of vascular dementia with a component of Alzheimer’s Dementia for several years. Client also has other multiple physical diagnoses. Client’s wife had reported that recently, client has become increasingly confused, anxious, agitated and quite often verbally aggressive towards her and their children. He seemed more paranoid as well for example he keeps checking the doors at night to ensure that there are locked and he also looks out of the window all the time. There has been a potential of physical aggression as client has been physically aggressive towards the household furniture for example he had smashed the house window with a chair recently. He has been confused particularly in the afternoons. Client’s wife also reported that client often repeats himself and makes statements of no meaning. Client had also recently finished a course of antibiotics for a chest infection. The initial contact with this client, author noted that client was very agitated and confused. He sentences were not making any sense and his was pacing and could not sit still. HE was also perspiring profusely. There was also some hyper salivation noted and client’s wife had stated client has been on serenace in a tablet form. Author was trying her best to calm client down and was to no avail. Client was not able to understand what the author was trying to do. Author felt she was talking too much and too fast as she felt that need to make the client to settle down. However that seemed to agitate the client even more. Client’s wife was clearly distressed by the whole scenario and was at the verge of breakdown herself. She was physically unwell herself with chronic illnesses and is visible worn out with exhaustion form caring for client who is unable to communicate his needs effectively. She had also stated their children do not come around anymore as they were busy with their own lives and do not enough time to share with her in caring for client. As the interview went further, client was getting more and more agitated and both clinicians with client’s wife very distressed. Attending clinicians were unable to identify what was the trigger to client’s agitation and anxiety. Mr. SS started to lash out at his wife and the attending clinicians. Finally the police were called in and the client was admitted to an inpatient psych geriatric unit for a medication and management of behaviors of concern as an involuntary patient under the Mental Health ACT (MHA). What made the interaction a critical incident:

The author found the outcome of the interaction very confronting and left the author feeling very confused, inadequate and incompetent in managing clients presenting with...
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