Nursing 305

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Nursing 305

• The Role of the Psychiatric Nurse

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Pre-requisites for the Role

• Self awareness is a key part of the psychiatric
  nursing experience.
• You must be able to examine personal feelings,
  actions, and reactions.

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Questions to ask yourself

• Why do I want to help others?
• Who am I?
• What do I value?
• Am I open to my feelings and can I express
  them?

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Role cont.

• What is the key therapeutic tool of the
  psychiatric nurse?

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Role cont.

• Answer use of oneself

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Some indicators of mental health

• Positive attitudes toward self, growth, and
  development
• Self-actualized
• Integrated self
• Autonomous
• Reality-perception
• Environmental mastery

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Indicators cont.

• Can a person adapt to changing needs throughout
  the life cycle?
• How much resilience does a person have?
• How does a person handle stress and adapt?
• What kind of coping mechanisms are used?

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Mental health as a process

• Mental health is .a lifetime process that
  includes a sense of harmony and balance for the
  individual, friends, family, and community it is
  more than the mere absence of a mental disorder

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FACT

• Nearly 50 of all people ages 15 to 54 have had a
  psychiatric or substance abuse disorder in their
  lifetime.

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Historical perspectives

• 1800s-The mentally ill were no longer treated as
  less than human. Treatment was provided in
  asylums.
• 1880- Linda Richards, the first American
  psychiatric nurse. Director of first school of
  psychiatric nursing McLean Hospital in
  Massachusetts.

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Historical perspectives cont.

• 1935- emergence of somatic therapies
• 1937- ECT
• After WWII major growth in psych nursing
• 1950s emergence of the role of the psych nurse
  use of psychotropic drugs
• 1952- Hildegard Peplau defined nursing as an
  interpersonal process, nurse role as counselor

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History cont.

• 1960- 1980 - Deinstitutionalization Movement
• Community Mental Health Centers Act
• Founding of the American Psychiatric Nurses Assoc
  and the ANA published standards of mental health
  nursing practice.
• 1980 to present -significant changes in mental
  health treatment focus on mental illness
  prevention

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Contemporary psychiatric nursing practice

• Reflects an interpersonal process
• Is a specialized area of nursing practice
  utilizing theories of human behavior and the
  purposeful use of self.
• The nurse-pt. partnership expands the nursing
  role to include pt-family advocacy, clinical
  competence, collaboration , fiscal
  responsibility, and legal-ethical parameters.

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Competent Caring3 domains of psych nursing

• Direct care
• Communication
• Management overlapped with teaching,
  delegating, and collaborating

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Competent Caringcont.

• Additional activities
• Make culturally sensitive health assessments
• Engage in case management services
• Provide a health care map for families to guide
  them to community services
• Provide teaching and counseling

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Levels of Performance

• Laws each state has its own nursing practice
  act, which regulates entry into the profession.
• Qualifications include education, work
  experience, and certification.
• 2 levels Basic-Psychiatric Mental Health RN
• Advanced- Advanced Practice RN Psych Mental
  Health Nurse

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Practice Settings

• Vary widely for the psych nurse.
• The role depends on the philosophy, mission,
  values of the setting, needs of the consumers,
  of clinical staff available, resources, and
  presence of strong nursing leadership.

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Focus for the future

• Psych nurses focus on
• -outcomes of care quality and cost
• -leadership skills-acting as change agents to
  advocate for the mental health needs of pts and
  families. Join organizations such as the American
  Psych. Nurses Assoc. (APNA) located in Washington
  DC
• -political action-increase political awareness to
  bring about changes in the MH delivery system.