Today I am working as a registered nurse at a specialty hospital for behavioral health clients. I am preparing to meet with a newly admitted client, F.A., whom has been medically diagnosed with social anxiety disorder. Social anxiety disorder, also known as social phobia is a chronic anxiety disorder marked by fear and excessive self-consciousness in public (Schub & March, 2018). I know from reading her chart that F.A. is a 47-year-old Caucasian female client who lives alone at her home in the country.
Delving into F.A.’s intake paperwork I find that she has voluntarily admitted herself for therapeutic milieu. She has stated that in the last few years it is increasingly difficult to do things that were once mundane parts of life, such as go to the grocery store. I pull into the parking lot and I look around at all the people and my heart just begins to pound. F.A. is quoted as saying. But what am I supposed to do? I cannot let my poor cats starve because I am afraid to go in public. I always feel that everyone is judging me, and when I go up to the checkout stand I notice that the cashier says hello to the person in front of me and then just rings up my items without greeting me. Takes my money and goes on to the next person in line. I notice she tells them hello, too, but not me. I feel like I am constantly being stared at and judged. I just hurry as fast as I can to get my shopping done and get out of there to get home. According to the National Institute of Mental Health, a misinterpretation of the behaviors and actions of other people is a major factor in social anxiety (Social Anxiety Disorder: More Than Just Shyness, n.d.). I read on to see that F.A. began to work nights about a year ago because overnights she is basically alone and has no interaction with people on her shift at an assisted living facility. She has been divorced for 8 years and has two adult daughters that have urged her to seek more in-depth care for this disorder. No history of physical violence or past or present substance abuse issues were disclosed.
The only recent interventions for this client have been via the pharmacological route. F.A. has been prescribed Venlafaxine, a serotonin-norepinephrine reuptake inhibitor which she has taken for almost 5 years along with lorazepam, an anti-anxiety medication. Last year her youngest daughter graduated from college. Because of her racing and pounding heart symptoms around large groups of people, her practitioner prescribed atenolol, a beta-blocker, so that she could attend the ceremony. Beta-blockers particularly atenolol and propranolol may be prescribed to complement therapy for social anxiety but must be done so off-label (Brown, 2018). F.A.’s eldest daughter, a registered nurse, is expecting her first baby in the next few months. Through a series of meetings at her mother’s residence,
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