Outpatient psychiatric nurse practitioner

stating, “I don’t want to be a writer. It’s stupid. It’s a stupid waste of time.” Chris responds, “That’s your dad talking.” Chris notes that Gordie is repressing his American dream because his father does not want him to be a writer. He then states that he wishes he was Gordie’s father because if he were, Gordie would not be considering taking shop courses instead of his college courses. Chris acts as a father figure to Gordie, who finds comfort and solace in his friends following his brother’s death. He resents the idea of taking college courses because he knows that it will isolate him from his friends, leaving him completely alone. When the boys finally make camp for the night and go to bed, Gordie is awoken by a nightmare of his father telling him “it should’ve been you” referring to Denny’s death. Chris’ American dream is to prove wrong the people that believe he will ultimately end up bad because of his family. When Gordie mentions that Chris could take college courses too, he states that no one would let him because they all think of him as “one of those lowlife Chamber kids.” He then explains how upset he was at being suspended from school. Chris was suspended because he stole the school’s milk money, not because he wanted to, but because he was expected to. When he became guilty and tried returning the money, his teacher used it to buy herself a new suit. He explains to Gordie that even if he tried to tell someone that story, they wouldn’t believe him because he’s nothing more than a kid brother to Eyeball Chambers. Deep down, Chris is a good kid whose dream is to succeed in life. His American dream is to make the adults in his life see him not as a punk, but as the intelligent, caring, boy that he is. One of the most important scenes in the film occurs when the four boys reach a bridge. They must decide whether to cross the bridge or walk an extra five miles to go around the bridge. This entire film represents the journey of childhood into adulthood, thus making the train tracks a symbol of the journey from one stage of life to another. The bridge, as well as the tracks in general, demonstrate that the path towards adulthood can be adventurous, dangerous, and downright scary. When the boys are about halfway across the tracks, a train comes along, forcing them to run. In this instance, the train symbolizes the trauma that the boys have experienced that have ultimately forced them to grow up quicker than average boys their age. When the boys get close to finding the body, they again are forced to make a decision regarding the direction they take. They can either walk the train tracks or cross a field into a forest and ultimately decide to walk through the field. By choosing this path rather than the tracks, this shows that the boys desire to make their own destinies rather than follow the path that has already been paved for them by their family members, community members, and society itself. When the boys finally find the dead body, Gordie decides that they will not take credit for finding it, as that is not the way to prove themselves to their community. They report the body anonymously and return back home. Gordie and Chris say goodbye to the other boys a

Sample Solution

When working with a patient in a crisis such as this one, the first step I would take is to assess for suicide risk and ensure that the patient is safe. Since my patient has already expressed suicidal ideations and plans to act on those thoughts, I would need to make sure that he has no access to firearms or any other weapons of lethal means (American Psychiatric Association [APA], 2013). Moreover, it is important to understand the severity of his suicidal ideations as well as his motivation behind them in order to determine how best to manage his current state. From our conversation so far, it appears that his primary motivation for considering suicide stems from feeling helpless in regards with the situation with his wife and children (APA, 2013). Therefore, my next step would be to provide him with some resources that can help him cope more effectively with this difficult time. This could include providing education about healthy coping strategies like talking through your emotions with family or friends and engaging in physical activities such as running, yoga or biking which have been linked to improved psychological functioning (O’Neal et al., 2021). Additionally, I also think it would be beneficial for him if he engages in counseling services either through telehealth therapy sessions or support groups where he can connect with individuals going through similar experiences. This could help normalize feelings of loneliness and hopelessness while allowing him process these events in a supportive environment (O’Neal et al., 2021). Given that part of our discussion included concerns regarding substance abuse behavior such as drinking alcohol at least six times per night after learning about her infidelity; it might warrant further investigation into whether formal treatment may be necessary depending on its frequency and duration since both alcohol use disorder (AUD) and major depressive disorder often co-occur together which can increase suicidality risk even further (Preston et al., 2021; APA ,2013). Therefore, during this time of crisis intervention phase I will involve multidisciplinary team members like psychologist ,social workers etc who specialize in addiction treatment when needed .It follows then we should move towards medication management phase where citalopram dose needs adjustment based on current level of depression .We also need monitor side effect profile especially cardiovascular symptoms .Finally,  due to close monitoring along psychosocial interventions we can reduce self destructing behaviors & ultimately improve quality life.