Fifteen minutes late, Shakyeela Al Enezi, a 19-year-old Arab-American female, comes into the office for her assessment with you, a psychiatric nurse practitioner. She is irritable, mildly agitated, and unpleasant with you. She is dressed and groomed meticulously, with perfectly matching make-up and nail polish and brightly colored clothes.
Shakyeela drops into a chair and sighs loudly. She waves a latest-generation iPhone in the air. “I’m only here because my mother made the appointment and said she won’t pay my phone bill if I didn’t show up. She thinks I have a problem, but I don’t, and I don’t want to be here.†She rolls her eyes and grimaces.
You attempt to engage Shakyeela and establish a therapeutic alliance, but Shakyeela just moans and groans, “I don’t have a problem so stop talking to me.†You do manage to establish that Shakyeela has no suicidal ideas, intention, or plan, but don’t get much else from your attempts to engage her in conversation.
After a short time, Shakyeela abruptly says, “That’s enough. I’m not staying any longer. This is just a waste of time.†She gets up and leaves your office without a backward glance.
From the intake form, you establish that Shakyeela has been regularly using heroin for the past two years. She has not been in any kind of treatment but indicated that her mother has been trying to get her to do something about it.
Questions
In one post, address the following:
What you will do next regarding Shakyeela?
What is your emotional reaction to this case presentation? Focus on your reaction as a person, not as a clinician.
How do personal feelings or responses, particularly related to cultural competency, influence the assessment or evaluation process of a psychiatric nurse practitioner?