Nursing Narrative (Essay Sample)

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The patient was 65 years old weighing 46 kg and height 178 cm. he had spent 32 years in and out of hospital. From observation, the patient had aimless behavior that was not constructive. Further, he depicted inappropriate and bizarre emotional behavior. Occasionally, the patient could burst into laughter with no apparent reason. He had difficulty feeling pleasure. Additionally, there were indications of false and fixed beliefs. Such delusions had, however, subsided in the view of the medical reports of the patient. Additionally, the patient had occasional grimacing. He lacked motivation and seemed withdrawn at the time of the observation and interview. He was additionally prone to hallucinations and saw, heard and talked to objects that others could not see. At the time of the interview, this did not happen and for the entire placement period, he hallucinated once.
Further, the patient depicted silly and strange behaviors. Occasionally, he made speeches that made no sense. During instances of calmness, the patient narrated how uncertain he had been about his identity. Given this, his values and interests changed rapidly. He said that he had been viewing all aspects and issues from the extreme. Everything was either good or bad. Nothing showed mixed sense of goodness. To him, there was no moderation of anything. These notions accounted for the numerous interview sessions that I had to cancel whenever he viewed me as an evil person. In the event that the patient looked up to someone on a particular day, he would totally look down upon the same person the following day (Davis 2009, 64). As a result, the patient has suffered unstable and intense relationship.
The patient had been diagnosed with Borderline Personality Disorder. Even though the patient had stringent relationship with people because of his uncertain moods, he had the fear of being abandoned. He could not tolerate being alone. Whenever he had totally looked down upon people and was left alone, he confessed feelings of loneliness, boredom and emptiness. At these moments, he expressed inappropriate anger. For a better part of his life, the patient confessed that he had never had never been in a long-lasting love relationship. He acted impulsively in relation to substance and drug use in addition to sexual relationships. His main struggle with the condition was the repeated cases of self-injury, overdosing and wrist cutting.
During the interview, the patient attested that he believed to be living a very normal life when he suffered more severe mental condition. He acclaimed that throughout the journey with the mental illness, he had endured stigma of immense degree. He, therefore, thought of himself as a victim. He felt as though he was snuffing out the only thing that could motivate his family and friends to help him; hope. He felt that there is a huge need to implode myths associated with mental illness. During interview moments that the patient showed amazingly stable mental and emotional capacity, he said that there was the need to show mentally ill persons that such diagnoses do not need to lead to oblique, painful lives. He had a feeling that people like him still deserved a chance to be happy and live productive lives. All that it calls for is the right resource.
Such resources include therapy, medication and always a measure of good luck. He called for support from friends and family to manage and banish their inner demons. In as much as his condition does not allow him to form long-lasting friendships, the patient said during one of the follow-up interviews that for his condition, he would love to be forgiven, loved and forge lifelong friendships. He believes that these are some of the most important complements to medication and therapy. He said that his situation had tremendously improved in the past 4 years given the support, care and love he receives from his niece, a medical doctor by profession.
A narration of self-destructive urges by the patient was appalling and utterly shocking. He said that at the time of self-destruction, he did not realize that he was dealing with himself. He supposed that he had developed a therapy that provided the things he needed for several years but never achieved. In his description, he was in hell. He learnt the tragedies associated with severe mental illnesses the hard way. He banged his head against the walls of the rooms he was locked in. At the age of 33, the patient was taken to the Institute of Living for mental care. He quickly became the only occupant of a unit called Tom II, a seclusion room for the most severely affected mental ill persons. The staff of the health facility saw no other alternatives. The patient said he habitually attacked himself. He burnt his wrists with cigarette and occasionally slashed his arms. He severely cruised his mid section and legs using any sharp object he could find around. In the seclusion room, there was only a chair, a small bed and a tiny window with metal bars. There were no weapons. He confessed that the more he stayed in the cell, his urge and deep desire to die deepened. After realizing that he had no weapon around, he resorted to the only thing that made sense to him. He banged his head on the hard floor and the walls.
These episodes and experiences of self-destruction of the patient were completely out of his control. According to him, he had an idea that someone else was hurting him. He felt like the pain was coming, someone was going to do it, but he had absolutely no control. In his mind, he longed for someone to help him. He called upon God and wondered why He could not come to his rescue. He confessed feeling totally empty at that time. He had no way of communicating what was going through his mind. He lacked a way of understanding it.
Looking at his childhood, there were no tangible clues to the condition that had destroyed his life for the past 32 years. He said that he was an excellent student and was natural in playing guitar. He was the fourth of eight children of a banker and a teacher. The patient was a troublemaker as a child, but this was normal at his age. However, his siblings became more accomplished ad were relatively more attractive. Probably, these caused the currents of distress that ran under the surface. Nobody took notice of any changes until he developed relentless headaches and was bedridden. A psychiatrist recommended that he seek medical attention at Institute of Living. The medical practitioners diagnosed him with schizophrenia. He was placed on dosage of Librium, Thorazine and other powerful drugs. Additionally, he was placed on Freudian Analysis. The doctors also strapped him down for electroshock treatments. The first time, he received 14 shocks. The second visit for the electroshock, he received 16 shocks. Nothing changed for the patient. Soon, he was placed on a seclusion room for the severely mentally ill.
Additionally, the patient said that a discharge summary sheet dates 16th July 1999 noted that during 21 months of hospitalization at the facility, he was the most mentally disturbed patient within the facility. He kept banging his head wherever he would. The tragedy remained for nobody cared what was happening to her. Medical care only made matters worse.
The patient’s ability to recover from the mental disarray of the extent portrayed before to a state of being able to respond sensibly to an interview can be explained with a number of psychological and sociological theories. 32 years back, the patient was considered mindless and without sense of direction. Medical diagnoses and medications did little to help him. He confessed that therapies did not remedy the situation. According to the client, his continued recovery lies in the mind. With the help of his niece, the patient has incessantly accepted himself for who he is. His desire and deep urge to kill himself arose from the disappointment of the gulf between the person he wanted to be and the person he actually became. This left him homesick for the life he would never experience or know, hopeless and desperate. He felt that the gulf was real and not bridgeable (Diamond 1992, 47).
Recovery process in such Borderline Personality Disorder calls for radical acceptance. From the emerging discipline of behaviorism, people can learn new behaviors. Acting differently from the usual can alter underlying emotions of a person. Suicidal persons have tried in several ways to transform without success (Chinn & Watson 1994, 21). The only way to get through to such persons is to acknowledge that their suicide attempts made sense. To people like this patient, the thought of dying is a sweet release from the bondage of sufferance.
According to popular beliefs, people are the architects of their personalities. Psychological theories hold a contrary opinion. People do not have much control over their perceptions and behavior (Charon 2006, 29). Several psychological theories attest that people’s personalities, feelings and thought progressions are the products of bodily processes they cannot control. Attribution theory refers to the process by which individuals offer explanation to the causes of events and behaviors (Faculty Of Nursing, University Of Iceland 2011, 95). The theory explains the various schemes that attempt to explain the processes. Explanatory attribution gives an explanation of how people understand the universe around them. With this form of attribution, people are able to make judgments on the probable causes of certain events.
Interpersonal attribution, on the other hand, involves understanding the cause of an event when those involved are more than one person. This is where one would like to explain the motive of his actions to others (Glass & Vladeck 2004, 83). People may question the reasons why so...