St Thomas University Clinical Situation Discussion

At least one academic resource

• Describe a clinical situation, in detail. (Who was it, when did it happen, what happened, what caused it to happen, where did it happen, how did it happen). Describing the clinical experience should take less than 3 minutes. Discussing your reflection should take 3-5 minutes.

HY is a 17-year-old white male, who came to the clinic for his usual monthly appointment. HY has been diagnosed with Schizophrenia disorder. Schizophrenia is a widespread neuropsychiatric condition that frequently has fatal effects and is accompanied by substantial abnormalities in cognition, behavior, and social functioning. 50% of cases are identified before the age of 25, with its beginning often occurring between the ages of 14 and 35 (Skehan & Devir, 2021). He started to experience symptoms at the age of 8. However, his auditory hallucinations began at the age of 14 and despite medication he still hears them daily. HY desperately want to have a “normal” life and wishes that he never had any of these symptoms.

• What feelings, prejudices, and biases did you experience during the interview? 

As I conducted my interview with HY, I myself wish he had never had these symptoms. I could see how the illness has been affecting HY daily life. He shared with me that the voices become really loud when he has to concentrate such as when taking a test. The voices put him down and tell him not to bother because he will fail anyways.

• How did you manage these anxieties, feelings, prejudices, and biases? 

I engaged HY and encourage him to define what “normal” was for him. He described

“normal” as not hearing the voices, and not being put down every day. We spoke about different medications that are used for schizophrenia and the possibility of a change in his medications.

• What assumptions did you make about children or families with mental illness? 

HY’s mom is very supportive of him and is insistent on his care. She is aware of his symptoms and what exacerbates them. She also wants to help alleviate the voices HY is experiencing and is open to trying newer medications. To reduce the severity of the illness, early diagnosis and therapy are essential (Skehan & Devir, 2021).

• What awareness did you develop during your clinical experience? 

After the interview with HY, I researched schizophrenia and adolescents to have a better understand of how the illness was different in adolescents. Patients with schizophrenia are at a high risk of committing suicide. 90% of young people who kill themselves have a mental illness, according to studies, and up to 30% of persons with schizophrenia will try suicide at some point in their lives1, making it crucial to monitor young people with schizophrenia for suicide risk (Skehan & Devir, 2021).

• Describe how you changed as a result of your clinical experience? 

Due to what I learned from my interview with HY and the research I did online regarding schizophrenia and adolescents how different schizophrenia presents versus an adult.

• Describe how this clinical situation will impact your advanced nursing practice? 

This clinical experience taught me to work together with the patient and family in order to find a reasonable solution to a problem. In this case HYdesperately wanted the voices to stop and we were able to explore different medication options to help reduce the voices.