Common dilemma faced by psychiatric nurse practitioners is determining who the “client” is.

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One common dilemma faced by psychiatric nurse practitioners is determining who the “client” is. Given that children are typically brought for treatment by their parents, describe how the psychiatric nurse practitioner would respond to a child who discloses they are indulging in illicit behavior and asks you not to tell his or her parents.

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.

God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

This is a complex ethical and clinical situation requiring careful consideration of the child’s well-being, parental rights, and legal obligations. Here’s a framework for how a psychiatric nurse practitioner (PMHNP) might respond:

1. Building Rapport and Assessing Risk:

  • Acknowledge the Child’s Disclosure: “I appreciate you telling me this. It takes courage to share something like that.”
  • Assess the Nature and Extent of the Behavior:
    • What specific illicit behaviors are involved?
    • How often are they occurring?
    • Are there any associated risks (e.g., substance abuse, self-harm, exploitation)?
  • Assess the Child’s Understanding:
    • Does the child understand the potential consequences of their actions?
    • What are their motivations for engaging in these behaviors?
  • Assess for Safety:
    • Is the child in immediate danger?

This is a complex ethical and clinical situation requiring careful consideration of the child’s well-being, parental rights, and legal obligations. Here’s a framework for how a psychiatric nurse practitioner (PMHNP) might respond:

1. Building Rapport and Assessing Risk:

  • Acknowledge the Child’s Disclosure: “I appreciate you telling me this. It takes courage to share something like that.”
  • Assess the Nature and Extent of the Behavior:
    • What specific illicit behaviors are involved?
    • How often are they occurring?
    • Are there any associated risks (e.g., substance abuse, self-harm, exploitation)?
  • Assess the Child’s Understanding:
    • Does the child understand the potential consequences of their actions?
    • What are their motivations for engaging in these behaviors?
  • Assess for Safety:
    • Is the child in immediate danger?

Explaining Confidentiality and Its Limits:

  • Honest and Age-Appropriate Communication: “I understand you don’t want me to tell your parents. However, as a healthcare professional, I have a responsibility to keep you safe. There are some situations where I have to share information, even if you don’t want me to.”
  • Specific Examples:
    • “If you are hurting yourself or someone else, I have to tell your parents so we can get you the help you need.”
    • “If someone is hurting you, I have to report it to keep you safe.”
    • “If the illicit behavior is very dangerous, I will have to inform your parents.”
  • Emphasize the Goal of Helping: “My goal is to help you, and sometimes that means involving your parents so we can work together to find solutions.”

3. Involving Parents (When Necessary):

  • Plan the Disclosure:
    • If the PMHNP determines that disclosure is necessary, they should plan how to share the information with the parents in a way that minimizes harm to the child-parent relationship.
    • Attempt to have the child be part of the discussion with the parents.
  • Therapeutic Approach:
    • Frame the disclosure as a collaborative effort to support the child’s well-being.
    • Focus on the child’s needs and the importance of family involvement in treatment.
  • Legal Considerations:
    • PMHNPs must be aware of state laws regarding mandatory reporting of child abuse, neglect, and dangerous behaviors.
    • Consult with legal counsel if there are any doubts about legal obligations.

4. Therapeutic Intervention:

  • Individual Therapy:
    • Provide individual therapy to address the underlying issues contributing to the child’s behavior.
    • Help the child develop coping skills and strategies for making healthy choices.
  • Family Therapy:
    • Involve the parents in family therapy to improve communication and address family dynamics that may be contributing to the child’s behavior.
  • Referral to Specialized Services:
    • If necessary, refer the child to specialized services, such as substance abuse treatment or crisis intervention.

Key Considerations:

  • Age and Maturity: The child’s age and maturity level will influence the PMHNP’s approach.
  • Severity of the Behavior: The severity and frequency of the illicit behavior will determine the level of intervention required.
  • State Laws: PMHNPs must be familiar with state laws regarding confidentiality and mandatory reporting.
  • Ethical Principles: The PMHNP must balance the ethical principles of autonomy, beneficence, and nonmaleficence.

By following these steps, the PMHNP can navigate this challenging situation in a way that prioritizes the child’s safety and well-being while respecting parental rights and legal obligations.

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