Nursing 305

The Role of the Psychiatric Nurse

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.

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?”

Role cont.

“What is the key therapeutic tool of the psychiatric nurse?”

Role cont.

Answer: “use of oneself”

Some indicators of mental health

Positive attitudes toward self, growth, and development

Self-actualized Integrated self Autonomous Reality-perception Environmental mastery

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?”

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

FACT

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

Historical perspectives

1800’s-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.

Historical perspectives cont.

1935- emergence of somatic therapies 1937- ECT After WWII major growth in psych nursing 1950’s –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

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

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.

Competent Caring3 domains of psych nursing

Direct care Communication Management overlapped with teaching,

delegating, and collaborating

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

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

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.

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.