Discussion Prompt
Rebecca Cole is a 39 years old, single, African Americanfemale. She has never been married or had children. She has been institutionalized at a state mental health hospital formore than 7 years since she was diagnosed with unspecified schizophrenia.She was diagnosed at age 21 and has undergone more than8 psychiatric hospital admissions over her lifespan. Ms. Cole hasbeen transferred to a local acute care hospital due to uncontrolleddiabetes and hypertension. She has been refusing bloodglucose monitoring daily, so the charge nurse on the womens floor has not beenable to check her blood sugar for 2 days. She has also been refusingher antihypertensive and antipsychotic medication for 3 days. Thishas now led to more uncontrolled hypertension and an increasein psychosis and behavioral issues today. The nursing staff has become very frustrated and voiced their issues with hospital administration because they dont feel the administration is listening to theirconcerns about the challenges faced on the psychiatric units, and particularly the challenges they are facing in caring forRebecca.
You are the PMHNP who is assigned and is managing her psychiatriccare while in the acute care hospital.
At this point, can Rebecca make her own healthcare decisions? Why orwhy not?What legal risk for the PMHNP could be associated withcaring for Rebecca in the acute care hospital setting?
How can integrative care be an approach that is utilized with this patient?
What other specialties should be involved and when she they be involved?
Discuss the potential ethical issues facing the staff nursescaring for Rebecca in both the acute care hospital setting currently and the state psychiatric hospital setting?
Why is continued integrative care a better option for patient outcomes and a better option from an ethical and legal perspective?
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer-reviewed journal evidence to support the students position.
Please review the rubric to ensure that your response meets the criteria.
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