What Should the Nurse Do?

Maria is a twenty-eight-year-old female who has been diagnosed with OCD and has been struggling with severe contamination fears, leading her to wash her hands repeatedly throughout the day. This ritual has resulted in red, chapped skin on her hands. Maria is distressed and finds it difficult to complete daily tasks or leave the house.

History: Maria’s symptoms began to appear in her early twenties and have gradually worsened. She has a family history of anxiety disorders. Previous treatments have included medication and outpatient therapy, with some improvement, but recent stressors have led to a relapse.

Treatment Plan: Maria’s treatment plan includes a combination of CBT with ERP, medication management with an SSRI, and coordination with a psychiatric nurse for education and ongoing support.

Sarah, a twenty-nine-year-old female, was referred to mental health services by her primary care physician. She reported experiencing memory gaps, feeling like she’s “watching herself from afar,” and periods where she acts like different people, including a timid child and an angry young male. Family members have also noted her shifting behaviors. Sarah’s history includes a traumatic childhood with physical and emotional abuse.

Symptoms: Distinct identity states, memory gaps related to personal information, confusion about personal identity, altered perceptions and behaviors

Diagnosis: After a thorough evaluation, Sarah was diagnosed with DID.

Treatment: Sarah’s treatment plan included establishing safety, psychotherapy focusing on integration and rehabilitation, collaboration with a multidisciplinary team, and regular monitoring and assessment.