Psychiatric care technicians (PCTs) are unlicensed assistive personnel that are an integral part of the acute care mental healthcare team. Which of the following choices would be an example(s) of overdelegation by the nurse to a PCT? The nurse directs the PCT to (Select All that Apply):

Choice A Reason: “I’d rather be dead than live like this. I do not want to be alive.”

This statement reflects suicidal ideation, which is a common symptom of major depressive disorder (MDD). Individuals with MDD often experience feelings of hopelessness and worthlessness, leading them to believe that life is not worth living. Suicidal thoughts are a serious concern and require immediate attention and intervention.

Choice B Reason: “If I can just keep ignoring my feelings, I’ll be fine.”

This statement indicates a form of denial or avoidance, which is also common in individuals with MDD. People with depression may try to ignore or suppress their feelings in an attempt to cope with their condition. However, this approach is generally ineffective and can lead to worsening symptoms over time.

Choice C Reason: “I deserve to be this way. I’ve not accomplished anything important in my life.”

Feelings of worthlessness and excessive guilt are hallmark symptoms of MDD. Individuals with depression often have a negative self-view and believe that they are failures or that they deserve to suffer. This distorted thinking pattern can significantly impact their overall well-being and quality of life.

Choice D Reason: “This is a bad episode, but I will be well soon.”

This statement reflects a more optimistic outlook, which is less common in individuals with MDD. While some people with depression may have moments of hope, the pervasive nature of the disorder typically leads to a more negative and hopeless perspective. Therefore, this choice is less likely to be heard during an intake assessment for MDD.

Choice E Reason: “I am determined to fight this episode and get through it.”

Similar to choice D, this statement indicates a positive and proactive attitude towards managing depression. While determination and resilience are important for recovery, they are not typically expressed by individuals during the acute phase of MDD. This choice is also less likely to be heard during an intake assessment for MDD.

Choice A Reason:

When a client with a personality disorder engages in self-destructive behavior, it is crucial for the staff to observe this behavior closely to ensure the safety of both the client and others around them. Self-destructive behaviors can include actions such as self-harm, substance abuse, or reckless activities that pose a significant risk to the individual’s well-being. By monitoring these behaviors, staff can intervene promptly to prevent harm and provide necessary support. Ensuring safety is a fundamental aspect of care in mental health settings, as it helps to stabilize the client and create a secure environment for their treatment and recover.

Choice B Reason:

Indulging the client’s wishes is not a recommended approach when dealing with self-destructive behavior. While it is important to understand and validate the client’s feelings, indulging their wishes can reinforce negative behaviors and hinder their progress towards healthier coping mechanisms. Instead, staff should focus on providing appropriate interventions and support that address the underlying issues contributing to the self-destructive behavior. This approach helps the client develop more constructive ways of meeting their needs and managing their emotions.

Choice C Reason:

While self-destructive behavior may provide a temporary outlet for feelings of anger and frustration, it is not a healthy or sustainable way to cope with these emotions. Encouraging or allowing such behavior can lead to further harm and exacerbate the client’s mental health issues. Staff should work with the client to identify and implement healthier coping strategies that effectively address their emotional needs without causing harm. This can include therapeutic interventions, counseling, and skills training to help the client manage their anger and frustration in more constructive ways.

Choice D Reason:

Assuming responsibility for the client’s behavior is not an effective way to reduce their anger and anxiety. In fact, it can create a dependency on staff and prevent the client from developing their own coping skills and sense of autonomy. It is important for staff to support the client in taking responsibility for their actions and learning how to manage their emotions independently. This empowerment is a key component of the therapeutic process and contributes to the client’s long-term recovery and well-being.