Simulation 8 Flashcards
(39 cards)
You are an Employee Assistance Program (EAP) counselor at a large health care facility. A 32-year-old male nurse, Richard, is referred to you by his supervisor. The referral indicates that he is an ICU nurse, and that he has been “highly volatile” with angry outbursts in the ICU, at times with patients and family members, but primarily with co-workers. You are requested to evaluate his situation, assist him with anger management, and report on his fitness for continued assignment in that high-stress setting.
You are an Employee Assistance Program (EAP) counselor at a large health care facility. A 32-year-old male nurse, Richard, is referred to you by his supervisor. The referral indicates that he is an ICU nurse, and that he has been “highly volatile” with angry outbursts in the ICU, at times with patients and family members, but primarily with co-workers. You are requested to evaluate his situation, assist him with anger management, and report on his fitness for continued assignment in that high-stress setting.
What is the purpose of the referral for Richard?
To address issues of angry outbursts in the workplace.
This understanding is crucial for evaluating his insight into anger management.
What does Richard hope to accomplish through counseling?
To gain control over his anger and become a better, calmer, and more dependable employee.
This is a meaningful, open-ended question that reveals his goals.
What could Richard’s belief about the cause of his emotional outbursts reveal?
It could reveal a great deal about his insight into his anger management issues.
Why is the extent and quality of Richard’s relational support system important?
It can aid in determining his capacity to relate well with others and better appreciate his insight into anger issues.
What is Richard’s current status regarding substance abuse?
He has been drug and alcohol free for about seven years.
His past history includes heavy drinking and episodic use of cocaine and methamphetamines.
How does Richard’s length of time in the ICU setting relate to his anger issues?
It is not immediately useful in determining his insight into angry outburst problems.
What has Richard been disciplined for at work?
Being overly rough with patients, angrily shouting at others, intimidating others, and using foul language.
What is Richard’s attitude towards counseling and direction?
He has been resistive to counsel and direction, especially from women administrators.
What does Richard’s communication style include?
He is clipped and intolerant, often walking out on staff and patients if he disagrees.
What issues need to be explored regarding Richard’s current marital situation?
There are no active marital issues indicated; he speaks highly of his spouse.
What is Richard’s stance on working in a stressful ICU setting?
He insists he will only work in ICU or ER settings and refuses to consider less demanding positions.
What is indicated regarding Richard’s efforts to remain clean and sober?
It is important to inquire about his AA attendance and relationship with a sponsor.
How does Richard deal with confrontation and disagreements?
He is unwilling to work out disagreements and sees quibbling as a waste of time.
What are the potential ethical obligations regarding Richard’s past violent behavior?
Counselors must consider the legal and ethical implications of reporting such disclosures.
What is the best response to Richard’s revelation of past violence?
Consult a lawyer to discuss legal and ethical obligations regarding the situation.
What is a key factor for placing a client on an involuntary hold?
The client must pose a known and immediate threat to themselves or others.
What did Richard state about his involvement in a violent incident?
He described a past incident where he stabbed a man, who he believed died as a result.
What does Richard’s disclosure about past violence imply for his counseling?
It raises concerns about his aggressive tendencies and potential danger to others.
What is Richard’s perception of lower-level supervisory staff?
He believes they are just ‘glorified line staff’ and feels no obligation to take direction from them.
What does the Tarasoff regulation state regarding threats of harm?
It applies when there is a current or planned threat of harm to another.
What is required for a client to be placed on an involuntary hold?
The client must pose a known and immediate threat to himself or others.
Is it indicated to address a client’s disclosure of aggressive tendencies in therapy?
Yes, it should be meaningfully addressed to explore the client’s past history of aggression.
Is it ethical to report a client’s dangerous behavior to the referring administrator without consent?
No, it would constitute a serious and unethical breach of confidentiality.
