Nurse Dave, Last night, I received the following text from a fellow reader:
10:35 p.m. thursday night, at subway, eating an italian sub, by
myself, 'man, i feel like a woman' by shania twain blasting on the
What is your diagnosis?
Thanks for the question Seth, obviously things aren't going well for this reader. At this point in time any decision that leads you to sitting alone and listening to Shania Twain has to come into doubt. It makes me think of other situations I've observed or even been a part of. The time I spent an hour inside a Best Buy playing Mario Kart because I didn't have anything better to do. The time I saw an overweight man wearing a Batman cape sitting alone in an amusement park. The time a former roommate of mine went out back to repeatedly hit a boat with a paddle in intense frustration. The boat wasn't the problem and really the subway sandwich isn't the problem either.
My nursing diagnosis (which is an actual thing, you can look it up) would probably involve situational low self esteem, powerlessness or possibly personal identity disturbance.
Some nursing interventions that might work -
- Encourage patient to identify strengths. (This can be tough when the patient is listening to Shania Twain)
- Assist the patient to reexamine negative perceptions of the situation. (For example a comment like, "Hey that sub looks pretty good!")
- Encourage increased responsibility for self. (Sign the patient up for cooking classes, get patient to look in the mirror, etc...)
- Implement individualized strategies to provide hygiene, diet, and sleep. (A text like the one above can only mean its been days since the patient has last bathed)
- Give the patient control over his or her environment. (For example let him choose the music when riding in the backseat of your car)
- Avoid using coercive power when approaching patient. (Careful here, the urge to shake the patient and demand that he turn his life around can be pretty strong)
- Assist with creating a timetable to guide increased responsibility in the future. (Just don't give him too much responsibility too soon. I don't know if he's ready)
Good luck Seth!