S. B. is a 27-year-old man who has been experiencing posttraumatic stress disorder (PTSD) for two years after his wife disappeared. At present, he regularly suffers from insomnia, depressive moods, anxiety, and the inability to improve relationships with his 5-year-old son. S. D. must reduce anxiety, refuse medication, attend a psychologist, go to church, etc. to achieve the outcome for each of the diagnoses.
Apparently, it is possible to suggest that such nursing interventions as anxiety reduction, the nursing process to stressor-related disorders, interventions on improving the sleeping schedule, sensible refusal from antidepressant medication, family consultations and continuation of spiritual practices will improve the patient’s condition.
Among the main challenges for S. B., it is possible to mention the necessity to defeat insomnia and the refusal of antidepressant medication. It is crucial for the improvement of the patient’s physical health because insomnia and drug habituation disturb S. B. the most deflecting him from a daily routine. Apart from that, it is necessary for S. B. to overcome such consequences of PTSD as depressive moods and anxiety, because it adversely affects the patient’s everyday life and provokes the following medication taking. Furthermore, there is an acute need to stabilize the emotional state of S. B. so that he would become able to rebuild emotional connections with his son and friends in the context of late events. At last, S. B. has to continue spiritual practices as they make a positive impact on his condition and, moreover, they are considered to be the features of the adaptive coping pattern.
It was already proved that the patient’s treatment should be better based on the principles of holistic nursing care rather than the traditional nursing. According to it, to defeat anxiety as one of the primary manifestations of PTSD, it is necessary to use such a nursing intervention as anxiety reduction. It has to minimize the patient’s apprehension, tension, and fear of an unidentified source of danger. Anxiety reduction includes providing objects symbolizing safety to the patient, listening attentively, encouraging verbalization of the patient’s feelings, teaching him various relaxation techniques, etc. (Bulechek, Butcher, Dochterman & Wagner, 2013, p. 83). Undoubtedly, this nursing intervention will address the patient’s unconscious. After completing the treatment, it is necessary to analyze if S. B. learned how to manage anxiety and became calmer, and if he does not feel a need for medication anymore.
Concerning depressive mood as one more painful PTSD symptom, it is possible to suggest the nursing process to stressor-related disorders as an appropriate intervention. The long-term goal of this method is to make the patient integrate with his stressful experience, to overview his relation to it, and not to admit the disease recurrence in the future. This intervention is considered to influence the patient’s consciousness more than the unconscious. It involves instructing the patient about coping strategies as a response to the trauma, discovering his basic beliefs about himself and the world around him, assimilation of a stressful event into his worldview, etc. (Townsend, 2015, p. 565). After completing the treatment, the patient should return to his normal life and refuse outright antidepressant medication.
As for insomnia which seems to be both a disease’s symptom and a trigger for other disease’s manifestations, it is more efficient to appeal for a complex of interventions, as insomnia is hard to overcome even after the elimination of the disease’s cause. For instance, such interventions as adjustment of day regimen, doing meaningful activities during daytime, monitoring frequency and duration of the patient’s sleep can be mentioned (“Nursing Management of Sleep Disorders,” 2013). In the case of S. B., it is also possible to come up with a creation of unique bedtime ritual. For instance, reading the fairy tales to his son before going to bed will improve not only the sleep but their relationships as well, influencing the S. B.’s emotional condition in the most positive way. Most of the interventions are to affect the consciousness of the patient. After completing the treatment, the patient should dispose of sleep disturbance.
It is utterly important to understand the consequences of long-term medication taking. For example, sudden refusal can often lead to unpleasant consequences such as a headache, depression, the mood changes, insomnia, etc. To avoid it, S. B. should gradually reduce the dose or change Paxil to the weaker medicine and after this, he might be able to refuse the antidepressant medication.
As for emotional stabilization, S. B. should continue attending weekly sessions with a psychologist and family consultations with his son. During these meetings, S. B. should get a feeling of active involvement in a recovery process which will help him to come back to normal life. After completing the treatment, the patient’s relationships with his son and friends should stabilize.
Regarding S. B.’s spiritual practices, it is necessary to continue them, as they help the patient to adapt to the stressful situation. The patient should have an opportunity to express his feelings and views on this subject. After completing the treatment, S. B. should adapt to his loss and reorganize his life.
Finally, it might be concluded that such nursing interventions as anxiety reduction, the nursing process to stressor-related disorders, improvement of the sleeping schedule, refusal from antidepressant medication, family consultations, and continuation of spiritual practices are of importance for S. B.’s condition. In the case of strictly following the specialists’ recommendations and self-improvement, S. B. will be able to manage anxiety, dispose of sleep disturbance and antidepressant medication. Furthermore, he will manage to put up with his loss and reorganize relationships with the surrounding.
References
Bulechek, G. M., Butcher, H. K., Dochterman, J. A., & Wagner, C. M. (Eds.). (2013). Nursing Interventions Classification (NIC). St. Louis, MO: Elsevier Mosby.
Nursing Management of Sleep Disorders. (2013). Web.
Townsend, M. C. (2015). Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based Practice. Oklahoma City, OK: F.A. Davis Company.