Case Study

The purpose of this assignment is to explore the personal and social implications of mental illness, as well as,
the ethical, legal and clinical practice implications related to a person experiencing mental illness being
admitted to a medical ward. Using a recovery and person-centred approach, explore the issues raised in the
case study and how you can support this person during your early shift.
Case Study Instructions:
You will be provided with a number of important documents related to this case study of a person who
experiences a major mental illness. These documents are contained in a folder on the learnonline course page.
Please access these documents in order to complete this case study. You are expected to use the Case Study
template (also available from the learnonline course page) to complete this case study. Please read the
sections on the Case Study template and ensure that you answer all sections.
You will be expected to analyse the case study documents, extract the main issues and reflect on how the
information impacts on the client, their family, and how it informs your nursing care and approach.
A total of at least 10 references are required for Steps 3, 5 & 6 only.
Assessment Task Scenario
You are a newly registered nurse working in a large metropolitan hospital on an early shift in a busy medical
ward. You have been allocated Amanda Citizen to care for as a 1:1 special in a single bed side-room. At 07:00
AM you are given the following hand-over by the night duty RN:
Amanda is a 29 year old woman admitted yesterday post overdose of Diazepam, Lithium Carbonate and
Quetiapine. Amanda has a diagnosis of Bipolar Disorder and is currently on an Inpatient Treatment Order –
Level 1 which requires review today. Overnight Amanda has been occasionally drowsy, but at other times very
restless and agitated. Her conversation has some delusional content at times. Amanda appears confused and
is likely to be experiencing a delirium related to the intentional overdose of prescribed medications.
Amanda has an intravenous line of normal saline one (1) litre over eight (8 ) hours – started four (4) hours ago.
Her pulse rate and her blood pressure has been within normal limits. I suggest you check her vital signs four
(4) hourly along with regular, four (4) hourly, neurological observations until she is reviewed by the treating
Medical team.
Amanda's behaviour has not presented any significant management problems overnight in the ward. However,
when Amanda presented to the Emergency Department she was in a severely agitated state and a Code Black
(Aggressive incident & security response) was initiated. Because of Amanda's fluctuating sensorium she is to
be considered 'at risk' and steps are needed to ensure her safety.
Amanda is not to be given any medication unless severely agitated. The Consultation-Liaison psychiatry team
are aware of her admission to the medical ward and will review Amanda later this morning. They told me that
over the next few hours it is likely that Amanda will become more alert and is likely to be more distressed and
agitated. I was asked to tell you to call for the Consultation-Liaison psychiatry team if you have any concerns.”
In a parting comment the night duty Registered Nurse states:
"I don't know why we are wasting our time looking after a woman who wants to kill herself when there are
plenty of sick people out there who need hospital beds".
Following this handover you have the time to review Amanda's admission notes where you find the following
documents which highlight past and recent concerns. (All of these documents will be made available within
thhe links below).
Emergency Department Mental Health Assessment
Private Psychiatrist letter to Mental Health case manager
Letter from employer to Mental Health case manager
10/15/2020 Order 328323456
https://admin.writerbay.com/orders_available?subcom=detailed&id=328323456 3/4
Letter from Mother to Mental Health case manager
Recent letter from identified client to Mental Health case manager