John was admitted to the ward for alcohol withdrawal after being found lying drunk in the street. According to the National Library of Medicine: Mental Health Nursing Assignment, QUB, Ireland

John was admitted to the ward for alcohol withdrawal after being found lying drunk in the street. According to the National Library of Medicine, alcohol withdrawal symptoms usually appear when an individual discontinues or reduces alcohol intake after a period of prolonged consumption. John had his own side room.

My first encounter with John was when I went to check on him to do his observation and, to try to build a therapeutic relationship, which is essential to maintaining his psychological well-being. John was uncooperative and didn’t try to engage in conversation; he kept telling me to go away and leave him alone. John’s physical appearance was poor: his clothes were ripped, dirty and foul-smelling. This suggested to me that John didn’t look after his physical well-being, although at the time of John’s admission it was believed there was no threat to his physical and mental well-being.

John has a history of alcohol addiction, which is both a mental and physical condition, which will affect his mental well-being. John has very little contact with family members or friends and spends most of his time alone, which affects his mental well-being. According to the National Library of Medicine (NCBI), hazardous alcohol intake has been found to be associated with low mental well-being which affects positive mental health and emotional well-being.

Shortly after his admission, John absconded from the ward: Security was notified, and the nurse in charge unsuccessfully tried to contact john and his next of kin. John then contacted the ward and told the nurse that he was going to kill himself. As John was off hospital grounds all the nursing staff could do was alert the police.

Later, the police arrived with John who was under the influence of alcohol. John was put on one-to-one observation, during which he took a bottle of alcohol from his coat and started drinking. This was removed by the healthcare assistant, who had to leave John alone briefly as the alcohol had to be removed from his sight and shown to the charge nurse, who documented it and disposed of it.

During this time John removed his shoelace and tried to choke himself with it. On returning to the sideward, when the healthcare assistant observed what was happening, she quickly approached him and cut the shoelace from around his neck.

After discussing the incident with the multi-disciplinary team, which included the lead nurse, the supervising nurse, the doctor, and the healthcare assistant doing the one-to-one, it was decided to refer John to the liaison team for a full examination of his mental state to see if he needed to be admitted to the psychiatric ward. This is a sign that the step approach to care was completed and John was later transferred to the psychiatric unit.

On observing this incident, I wanted John to receive proper treatment and care to meet his needs in a safe and secure environment, I also wanted to make sure that John was aware of his situation leading up to his admission and the consequences this had on his own safety and wellbeing.

I needed to ensure that John had no other underlying health conditions so that when he was fully fit for discharge he had somewhere safe and secure to go to. I checked regularly with the healthcare assistant doing the one-to-one to see if either of them required anything and updated the nurse looking after John.

Patient well-being was offered during this time: John lay resting in his room: he didn’t want to do anything and didn’t want to listen or engage, so he was not forced to do either.