The Hispanic population is no stranger to hard times and struggles in life, just like any other culture here in the melting pot of America. Many are first and second generation immigrants who traveled to America in search of a better life for themselves and their families. They come with their own traditions, values, and belief systems that make them who they are as a culture. At times these values and beliefs can be challenged when they don’t fall in line with American beliefs, especially regarding healthcare. When this happens it’s imperative that respect and sensitivity to cultural needs are shown when providing medical care. Healthcare providers must educate themselves about different ...view middle of the document...
R.A. is a 17 year old Hispanic male that presented to Aurora Behavioral Health Care (ABHC) by police on a 5150 hold due to command auditory hallucinations telling him “to kill myself” and that “I am worthless.” R.A. stated that he heard two male and one female voice once or twice a week. He stated he was exhausted and wanted these voices to go away. Since being admitted 7 days prior, his mother admitted him voluntarily on the basis that the voices have dissipated but he still heard “noise” in his head and complained of still being exhausted. He claimed his support system was his mother because she listened to him and he felt comfortable talking to her about the hallucinations. Playing the guitar at home quieted his mind and was soothing to him when he felt overwhelmed by the hallucinations. R.A. stated his mom refilled his home medications for him at the pharmacy and he took them regularly at home. R.A. also stated he tried to commit suicide by cutting his wrists in the past but had no desire to harm himself or others during his admission.
R.A. wore clean pajamas all day and behaved calm and cooperatively on both occasions that we spoke. He answered my questions with a flat affect and in a monotone two or three word response, very rarely elaborating. R.A. stated feeling anxious lately; he believed his medication was not working because he would still hear “noise” in his head. He admitted to feeling depressed but denied any changes in appetite or energy level. He complained of waking up multiple times throughout the night and feeling hopeless. R.A has a history of previous suicide attempts by cutting his wrists which was triggered by command hallucinations and led to hospitalization. R.A. denied any homicidal ideation or history of violence. Thought contact is intact, however he was experiencing auditory command hallucinations that told him to kill himself. His immediate, recent and past memory is good and he is doing “okay” in school with passing grades. He attends a special needs school with a class size of 4-5 students that he enjoys more than public school. R.A. denies any drug and alcohol use in his history.
Providing pharmaceutical support had been challenging when caring for this patient. The medical record states his mother initially refused all medications outside of what her son was taking at home stating she “doesn’t want him on all this medication.” During a family meeting, R.A’s mother expressed her concern about introducing any new medications to her son’s regimen but did not elaborate on the root of her concern per the social worker’s note. R.A.’s mental illness was not well controlled on the medication regimen at home due to his symptoms on admission and this was explained to the mother during the family meeting and through multiple phone calls.
Nursing Priority and Plan of Care
As a nurse, the primary focus for this patient would be educating the patient and his mother about...