Advanced Forensics

Clinical placements have been crucial learning opportunities for me throughout the course. I have gained real-world experience in handling different diseases. I have also practiced the theory I learn in the classroom. However, I have had a few misses as I strive to meet diverse patient needs. The most memorable case that I had a miss involved Mr. P (not his real name). Mr. P was a 65-year-old veteran enrolled in Afghanistan before he retired from service. While in Afghanistan, Mr. experienced several traumatic events, including fire combats to the death of his best friend from an IED. He presented with increased anxiety and panic attacks, marked by muscle tension, alertness, and perspiration when engaging in challenging tasks such as driving in traffic.

During the placement, I worked under a registered nurse, but I was assigned to the assessment of Mr. P. I did not ask more questions about what happened in Afghanistan or what Mr. P felt about the experience. The patient was accompanied by his wife, and according to the symptoms he presented, he was diagnosed with adjustment disorder, a condition that involves behavioral response to a change in the individual’s life. The doctor recommended family therapy for the patient. The family was advised on adjusting, including changing some communication patterns and interactions within the family. The condition was suppressed with the support of his family.

However, I feel that situation was not addressed effectively. There are things I would do differently if the case occurred again in my practice. Firstly, I would want to know what Mr. P thinks about challenging incidents that occurred during his time in service. Thousands of people in service and others retired have developed Post-traumatic Stress Disorder (PTSD) due to their experiences in service (Reisman, 2016). Mr. P had mentioned that he witnessed many traumatic incidents, including the death of his best friend. Perhaps these events were responsible for the panic attacks he experienced when he sought medical help. Seeking more information about Mr. P’s feelings about his past life in the military is part of the assessment stage of the nursing process.

Secondly, as part of nursing interventions to address the patient’s panic attacks, I would discuss the reality of the situation with him to educate him on healthy coping strategies while being sensitive to the patient’s feelings. I would want to understand what Mr. P fears, including what triggers that fear. I would acknowledge his challenging past, noting what we can change and what we cannot to improve his control over his life. Based on my experience after encountering Mr. P, there could be triggers in his life that tend to remind him of what happened in the past (Gimigliano et al., 2022). I would teach him some healthy coping strategies, including listening to music and relaxing his mind to help him deal with the triggers. I would reassure Mr. P that panic attacks are normal after experiencing a traumatic event. I would do all these nursing practices while showing empathy and compassion toward his feelings.

References

Gimigliano, F., Young, V. M., Arienti, C., Bargeri, S., Castellini, G., Gianola, S., Lazzarini, S. G., Moretti, A., Heinemann, A. W., & Negrini, S. (2022). The effectiveness of behavioral interventions in adults with post-traumatic stress disorder during clinical rehabilitation: A rapid review. International Journal of Environmental Research and Public Health, 19(12), 7514. https://doi.org/10.3390/ijerph19127514

Reisman, M. (2016). PTSD treatment for veterans: What’s working, what’s new, and what’s next? P&T, 41(10), 623–634. https://doi.org/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047000/