Schizophrenia refers to a chronic psychiatric disorder that is expressed by various psychotic symptoms. According to Khan et al. (2015), schizophrenia’s symptoms are categorized as negative, positive, and cognitive. Positive symptoms are associated with the lost touch on reality, and they include disorganized speech, hallucinations, and delusions. The negative symptoms are characterized by social withdrawal, anhedonia, and affective flattening. The cognitive category comprises of many cognitive dysfunctionalities.
Clinical Situation
On third November 2020, during my morning shift in Minds Over Matter clinic, I met J.M, who had schizophrenia. The client sat at the edge of the seat when he entered my office. He also kept on looking up now and then as he answered my questions. Suddenly, there was a little knock on the door, and immediately a colleague entered the room. Instantaneously, J.M stood up, grabbed his chair, and threw it towards my colleague, who rapidly slept on the floor leaving. Luckily, she was not hit. I was very terrified, but I tried to compose myself to talk to the client, who was then screaming and shouting the words, "Go away from me."
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Discussion
During the clinical experience, I was afraid and perceived J.M as unpredictable, dangerous, and unreliable. However, I suppressed the prejudices as I was determined to help him. Therefore, to develop a rational and fair judgment, I immediately asked the nurse to leave the room and then calmed the patient, who returned to his seat.
To determine whether J.M was dangerous, I asked him about the history of the hallucinations he was experiencing. J.M explained that the condition had worsened when he changed his medications to methylphenidate. Drugs with strong dopaminergic effects, such as methylphenidate and L-dopa, can induce hallucination (Kurn et al., 2012). Therefore, the new medications J.M was taking induced hallucinations resulting in dangerous behavior.
Reflection
Most of the experiences of the mentally ill parents are similar to those of other parents. However, people assume that the mentally ill lack family support and victimized, leading to the problems they experience. During the encounter with J.M, I understood that stereotyping is not wrong as it can help make a quick judgment, although it should be followed by the desire to understand the individual cases to make a fair judgment (Rossler, 2016). Due to the clinical encounter, I will try to do away with stereotyping of the mentally ill, as it can affect my judgment. The incident made it clear that personal bias can cloud one's judgment and the overall performance in the clinical practice. Therefore, as an advanced practice nurse, I will focus on the patients' data, handling every case individually for effective results.
References
Kahn, R., Sommer, I., Murray, R., Meyer-Lindenberg, A., Weinberger, D., Cannon, T., O, Donovan, M., Correl, C., Kane, J. & Os J. (2015). Schizophrenia 1 (1). https://doi.org/10.1038/nrdp.2015.67
Rössler, W. (2016). The stigma of mental disorders: A millennia ‐ long history of social exclusion and prejudices. Journal Of Science And Society , 17 (9), 1250–1253. https://doi.org/10.15252/embr.201643041
Santosh, K., Soren, S., & Chaudhury, S. (2012). Hallucinations: Etiology and clinical implications. Industrial Psychiatry Journal , 18 (2), 119-126. https://doi.org/10.4103/0972-6748.62273
